The Retina Reference

Arterial Macroaneurysm Confused for Neovascular AMD

83-year old female, whom recently moved to the area, presented to establish retina care. She has a history of exudative macular degeneration in the right eye, receiving two rounds of ANTI-VEGF injections at her former place of care. Upon dilated fundus exam and SD-OCT, it was questioned if her diagnosis of exudative macular degeneration was correct. Fluorescein angiogram was obtained, and a new diagnosis of a ruptured macroaneurysm was given. Note the localized area of hyper-reflectivity on the FA (green arrow), noting a small aneurysm that has ruptured, with subretinal blood noted as the black splotches around the aneurysm. The SD-OCT also shows subretinal blood, but could also be confused with an active subretinal neovascular membrane, from exudative macular degeneration. Observation, rather than intravitreal injections was recommended, as the blood will clear with time.