Macroaneurysm - Treated with Focal Laser

These photographs come from a 92-year-old female with a long history of high blood pressure. In 2007, she was also diagnosed with type II diabetes. Her vision at her initial exam in 2013 was 20/20 in the right eye and 20/25 in the left. Four years later in 2017, she complained of seeing an intermittent black spot in her vision. Her visual acuity tested to be 20/50 in both eyes. Fundus examination showed macroaneurysms. Fluorescein angiography (FA) images reflects these findings. In the right eye, a macroaneurysm is present along the inferiotemporal arcade (yellow arrow). In her left eye, an arterial macroaneurysm is seen along the superonasal arcade (green arrow). Optical coherence tomography (OCT) scans show subretinal fluid underneath her fovea in both eyes (red arrow) with intraretinal hemorrhage superior to the macula in the left eye (blue arrow). To prevent decrease vision, focal laser was administered to her left eye. In July her vision was 20/25 in the right eye and 20/32 in the left. OCTs show the fluid in her left eye to be resolving. Macroaneursyms are associated with hypertension and are typically prevalent in older women. With control of blood pressure and focal laser as indicated the prognosis is usually good.