CASE DESCRIPTION
A 66-year-old female underwent an annual ophthalmologic examination by her family doctor. At her last visit, fundus examination revealed a retinal arterial microaneurysm (RAM) and mild retinal hemorrhage of the right eye on ultra-wide-field pseudo-color fundus images (Figure A). She had no visual symptoms; therefore, her family doctor ordered a follow-up visit. Five days later, she returned due to the feeling of a strong floater in her right eye. Vitreous hemorrhage associated with the RAM was observed (Figure B). Vitrectomy was performed for removing the vitreous hemorrhage, and a laser was applied to the RAM.
There are many treatments for RAM, but no standard treatment protocol has been established. Most RAMs have a benign course of thrombosis, fibrosis, and spontaneous resolution, and the vision returns to its previous state.1 Therefore, RAM with no symptoms is generally followed up. When edema or exudates due to RAM cause vision loss, photocoagulation is usually considered.2Photocoagulation may be performed directly on macroaneurysms to facilitate involution.
Preventive photocoagulation for the RAM in the annual ophthalmologic examination might have prevented vitreous hemorrhage.