Abstract
Purpose :
The underlying etiology of peripheral retinal hemorrhages and peripheral microaneurysms is unknown and subject to debate. In this study, we aim to describe cases of asymptomatic peripheral retinal hemorrhage or microaneurysms attributed solely to presumed vitreous base traction using ultra-widefield imaging (UWFI).
Methods :
This is a retrospective, consecutive series of asymptomatic patients with peripheral retinal hemorrhage or microaneurysms. UWF fundus photography, fundus autofluorescence, fluorescein angiography, and/or optical coherence tomography were obtained.
Results :
We report nine adult cases with asymptomatic peripheral retinal hemorrhages and/or microaneurysms. These findings were observed on a routine eye examination or as an incidental finding in the contralateral eye of patients presenting a retinal break or detachment. On UWFI, the distinguishing features of peripheral retinal hemorrhage and microaneurysms due to vitreous base traction comprised their pinpoint shape and their location at the vitreous base, particularly in the far temporal and superior retinal periphery. UWF fluorescein angiography showed punctate hyperfluorescent spots with minimal to no leakage. Optical coherence tomography demonstrated signs of evolving posterior vitreous detachment. Management was limited to observation, with stable microaneurysms and resolution of hemorrhages with time.
Conclusions :
UWFI has led to the identification of vitreous base vasculopathy. Observation is appropriate in these cases if targeted workup is unrevealing.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.