This retinal vascular condition affects older patients between the age range of 50-80 with a history of hypertension (high blood pressure). About 50% of these patients have a history of heart disease and arteriosclerosis (“hardening” of the arteries).
A macroaneurysm can occur in any retinal artery and is clinically visible as a focal dilation of the arterial wall. Sometimes a fluorescein angiogram is needed to distinguish the macroaneurysm. This weak spot is like a bald spot on a tire and can lead to rupture. This rupture causes bleeding (hemorrhage) inside the eye. Usually, this hemorrhage has multiple layers—under the retina, in the retina and in front of the retina into the vitreous cavity.
Most retinal macroaneurysms have a good prognosis. It is important to control the blood pressure. If leakage occurs in the macula (central vision), sometimes laser is required. If bleeding causes a vitreous hemorrhage obscuring your vision, a vitrectomy maybe needed if the blood does not disappear on its own.