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 Table of Contents    
CLINICAL IMAGE
Year : 2020  |  Volume : 13  |  Issue : 2  |  Page : 102-103  

Multimodal imaging of an isolated retinal venous macroaneurysm


1 Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
2 Department of Surgery, Aga Khan University Hospital; Department of Ophthalmology, Shahzad Eye Hospital; Department of Ophthalmology, South City Hospital, Karachi, Pakistan

Date of Submission11-Oct-2019
Date of Decision31-Oct-2019
Date of Acceptance01-Apr-2020
Date of Web Publication28-May-2020

Correspondence Address:
M A Rehman Siddiqui
Aga Khan University Hospital, Stadium Road, Karachi 74800
Pakistan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ojo.OJO_231_2019

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   Abstract 


We report a case of a young male with symptomatic isolated venous macro-aneurysm without any associated systemic disease. Multi modal imaging was useful in making the correct diagnosis. To the best of our knowledge, primary isolated venous macro-aneurysm has not been reported previously.

Keywords: Multimodal imaging, retina and intraretinal edema, venous macroaneurysm


How to cite this article:
Maroof Hussain SZ, Rehman Siddiqui M A. Multimodal imaging of an isolated retinal venous macroaneurysm. Oman J Ophthalmol 2020;13:102-3

How to cite this URL:
Maroof Hussain SZ, Rehman Siddiqui M A. Multimodal imaging of an isolated retinal venous macroaneurysm. Oman J Ophthalmol [serial online] 2020 [cited 2020 Jul 6];13:102-3. Available from: http://www.ojoonline.org/text.asp?2020/13/2/102/285298



Macroaneurysm (MA) can be classified into four categories: arterial, capillary, collateral associated, and venous.[1] Venous MAs are further divided into secondary MAs, associated with disease and isolated MAs. Unlike arterial retinal MAs, there is insufficient data about retinal venous MAs.[2] In literature, only three cases of isolated retinal venous MA have been published to date.[3],[4],[5] In all three cases, there were associated conditions. Here, we report the fourth case of isolated venous MA; however, unlike the other three cases, the patient in our case was completely fit and healthy except the blurred vision.

A 45-year-old Asian nonsmoker man with no known comorbids presented with a complaint of gradual blurring of vision in the left eye for the past 6 months. He had no ocular or systemic history, particularly no hypertension. Fundus examination of the left eye showed a circinate arrangement of exudates juxtafoveally [Figure 1]a. Similarly, optical coherence tomography showed hyper-reflective exudates in the middle retinal layers surrounded by hyporeflective intraretinal edema [Figure 1]b and subfoveal localized neurosensory retinal detachment (not shown). A circular lesion with hyper-reflective border was noted in the middle retinal layers (white arrow). This represented saccular dilation of vasculature in the retina. The photoreceptor layer was intact. Fundus fluorescein angiography showed a normal choroidal and arterial phase in the left eye. Venous phase showed pinpoint leakage of the dye at the branching of second-order vein. There was leakage from venous MA, which led to intraretinal edema [Figure 1]c and [Figure 1]d. Of note was the surrounding normal vasculature, ruling out previous vascular occlusion. Examination of the right eye was unremarkable.
Figure 1: (a) Exudates juxtafoveally.(b) Optical coherence tomography showing hyper-reflective exudates and intraretinal edema. (c and d) Fundus fluorescein angiography showing leakage from venous macroaneurysm

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Cousins SW, Flynn HW Jr, Clarkson JG. Macroaneurysms associated with retinal branch vein occlusion. Am J Ophthalmol 1990;109:567-70.  Back to cited text no. 1
    
2.
Robertson DM. Macroaneurysms of the retinal arteries. Trans Am Acad Ophthalmol Otolaryngol 1973;77:OP55-67.  Back to cited text no. 2
    
3.
Brourman ND, Goldberg RE, Augsburger JJ, Grohsman J. Isolated venous macroaneurysm. Ophthalmic Surg 1990;21:646-8.  Back to cited text no. 3
    
4.
Khairallah M, Ladjimi A, Messaoud R, Ben Yahia S, Hmidi K, Jenzeri S. Retinal venous macroaneurysm associated with premacular hemorrhage. Ophthalmic Surg Lasers 1999;30:226-8.  Back to cited text no. 4
    
5.
Kaiser HM, Pagani JM. Isolated retinal venous macroaneurysm. Optometry 2005;76:522-5.  Back to cited text no. 5
    


    Figures

  [Figure 1]



 

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