Ruptured Arteriolar Macroaneursym

This 70-year-old female presented for an evaluation of decreased vision, distortion and spots in her field of vision. She had a history of hypertensive retinopathy with mild retinal hemorrhages in the past. Fundus exam showed a ruptured arteriolar macroaneurysm and RPE mottling in the right eye. The photos above show a small macroaneursym (green arrow) with surrounding hemorrhage (blue arrows). No treatment was recommended in this case. Patient was reassured the hemorrhage would clear on its own. She was encouraged to stop smoking and control her high blood pressure.