Definition: Dilatation of vascular structure between 100-250 microns.
Site: Usually superotemporal at arteriovenous crossing or arteriolar bifurcation.
Demographics: Elderly female with hypertension.
Asymptomatic or sudden vision loss.
Tri-layer bleed – subretinal, intraretinal or sub ILM bleed +/- retrohyaloid or VH.
ERM after resolution.
Macular hole formation following ruptured MA.
Investigations: FFA, ICG (pulsatile lesion), OCT, systemic evaluation (HTN and CVS).
Differential diagnosis: RVO ; angioma ; nAMD ; choroidal melanoma.
Asymptomatic – observation
Laser photocoagulation at macroaneurysm or perianeurysmal – macular oedema associated MA (take months to resolve) – risk of BRAO or CNV.
YAG hyaloidotomy – sub-ILM or retrohyaloid bleed.
Pneumatic displacement – small subfoveal bleed
PPV – dense VH
Anti-VEGF – early promising results for MA associated macular oedema.