Imaging of Macroaneurysms Occurring During Retinal Vein Occlusion and Diabetic Retinopathy by Indocyanine Green Angiography and High Resolution Optical Coherence Tomography

Background: Macular edema occurring after retinal vein occlusion (RVO) or diabetic retinopathy (DR) may be due to the development of capillary and/or venous macroaneurysms (MAs). Here, we investigated the respective contribution of fluorescein angiography (FA), of indocyanine green angiography (ICGA) and of high-resolution optical coherence tomography (HR-OCT) to their detection.

Methods: Review of the charts of six consecutive patients with MAs secondary to RVO (n = 4) or DR (n = 2). For each patient, FA, ICGA and HR-OCT data were analyzed and compared.

Results: All detectable MAs were detected by ICGA, while in three eyes FA failed to show them. Overall, ICGA provided a better delineation of MAs than FA. In all cases, HR-OCT identified MAs under the form of a vascular structure with a reflective wall surrounding a lumen containing variably reflective material.

Conclusions: MAs can develop during the course of RVO and DR. ICGA and HR-OCT improves the identification of capillary and venous MAs, and may thus be of interest to better identify sites of blood-retinal barrier rupture during chronic macular edema due to RVO or DR.