Intravitreal Ranibizumab Therapy for Retinal Arterial Macroaneurysm

Overview

Journal Int J Clin Exp Med

Specialty General Medicine

Date 2015 Sep 18

PMID 26379984

Citations 8

Authors

Muhammet Kazim Erol

Berna Dogan

Deniz Turgut Coban

Devrim Toslak

Ayse Cengiz

Deniz Ozel

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate the anatomic and functional results of intravitreal ranibizumab injection for treatment of symptomatic retinal arterial macroaneurysm (RAM).

Materials And Methods: A series of seven patients (seven eyes) who had been diagnosed with symptomatic RAM were assessed by comprehensive ophthalmologic examination, fluorescein angiography (FA), optical coherence tomography (OCT), and indocyanine green angiography (ICGA). All patients were treated by intravitreal ranibizumab injection within one week of diagnosis and retreated upon evidence of persistent serous detachment or hemorrhage involving the macula on OCT. Anatomical recovery was examined by FA, OCT, and ICGA. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated using the Snellen chart and optical coherence tomography, respectively, at baseline; at 1, 3, and 6 months; and at the final visit. The BCVA and CMT values at baseline and the final visit were compared using the Wilcoxon signed rank test and determination of logarithm of the minimal angle of resolution (logMAR) of BCVA value.

Results: Over a mean follow-up period of 10.86 ± 5.4 months, significant visual and anatomical recovery was observed, with visual acuity improving by three or more lines in all seven patients. The mean logMAR of BCVA improved from 1.09 ± 0.60 to 0.16 ± 0.16 (p = 0.018) and mean CMT decreased from 427.5 ± 132.4 μm to 208.7 ± 23.1 μm (P = 0.018). No complications were observed with intravitreal ranibizumab injection.

Conclusion: İntravitreal ranibizumab is an effective therapy for symptomatic RAM, improving BCVA and decreasing CMT.

Citing Articles

Outcomes of combined treatments in patients with retinal arterial macroaneurysm.

Wang C, Cao G, Xu X, Wang J, Zhang S Indian J Ophthalmol. 2021; 69(12):3564-3569.

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Retinal detachment following focal laser to ruptured retinal artery macro aneurysm.

Avadhesh O, Divya B Rom J Ophthalmol. 2021; 65(1):70-72.

PMID: 33817437 PMC: 7995508. DOI: 10.22336/rjo.2021.13.

Retinal Arterial Macroaneurysms: Updating your Memory on RAM Management.

Goldhagen B, Goldhardt R Curr Ophthalmol Rep. 2019; 7(2):73-79.

PMID: 31827984 PMC: 6905516. DOI: 10.1007/s40135-019-00202-3.

Intravitreal ranibizumab or conbercept for retinal arterial macroaneurysm: a case series.

Lin Z, Hu Q, Wu Y, Xu J, Zhang Q BMC Ophthalmol. 2019; 19(1):18.

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Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms.

Maltsev D, Kulikov A, Uplanchiwar B, Lima L, Chhablani J Int J Retina Vitreous. 2018; 4:28.

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References

Chanana B, Azad R . Intravitreal bevacizumab for macular edema secondary to retinal macroaneurysm. Eye (Lond). 2008; 23(2):493-4. DOI: 10.1038/eye.2008.98. View

Campochiaro P, Hafiz G, Shah S, Nguyen Q, Ying H, Do D . Ranibizumab for macular edema due to retinal vein occlusions: implication of VEGF as a critical stimulator. Mol Ther. 2008; 16(4):791-9. DOI: 10.1038/mt.2008.10. View

Cho H, Rhee T, Kim H, Han J, Lee D, Cho S . Intravitreal bevacizumab for symptomatic retinal arterial macroaneurysm. Am J Ophthalmol. 2013; 155(5):898-904. DOI: 10.1016/j.ajo.2012.12.003. View

Tsakpinis D, Nasr M, Tranos P, Krassas N, Giannopoulos T, Symeonidis C . The use of bevacizumab in a multilevel retinal hemorrhage secondary to retinal macroaneurysm: a 39-month follow-up case report. Clin Ophthalmol. 2011; 5:1475-7. PMC: 3206118. DOI: 10.2147/OPTH.S23535. View

Pieramici D, Rabena M, Castellarin A, Nasir M, See R, Norton T . Ranibizumab for the treatment of macular edema associated with perfused central retinal vein occlusions. Ophthalmology. 2008; 115(10):e47-54. DOI: 10.1016/j.ophtha.2008.06.021. View

Wenkstern A, Petersen H . Intravitreal ranibizumab in retinal macroaneurysm. Graefes Arch Clin Exp Ophthalmol. 2010; 248(11):1667-70. DOI: 10.1007/s00417-010-1380-3. View

Brown D, Sobol W, Folk J, Weingeist T . Retinal arteriolar macroaneurysms: long-term visual outcome. Br J Ophthalmol. 1994; 78(7):534-8. PMC: 504857. DOI: 10.1136/bjo.78.7.534. View

Lewis R, Norton E, GASS J . Acquired arterial macroaneurysms of the retina. Br J Ophthalmol. 1976; 60(1):21-30. PMC: 1017462. DOI: 10.1136/bjo.60.1.21. View

Toth C, Morse L, Hjelmeland L, Landers 3rd M . Fibrin directs early retinal damage after experimental subretinal hemorrhage. Arch Ophthalmol. 1991; 109(5):723-9. DOI: 10.1001/archopht.1991.01080050139046. View

10.

Lavin M, Marsh R, Peart S, Rehman A . Retinal arterial macroaneurysms: a retrospective study of 40 patients. Br J Ophthalmol. 1987; 71(11):817-25. PMC: 1041318. DOI: 10.1136/bjo.71.11.817. View

11.

Tonotsuka T, Imai M, Saito K, Iijima H . Visual prognosis for symptomatic retinal arterial macroaneurysm. Jpn J Ophthalmol. 2003; 47(5):498-502. DOI: 10.1016/s0021-5155(03)00104-7. View

12.

Javey G, Moshfeghi A, Moshfeghi A . Management of ruptured retinal arterial macroaneurysm with intravitreal bevacizumab. Ophthalmic Surg Lasers Imaging. 2011; 41(4):1-5. View

13.

Meyers S, Lewis H . Indocyanine green angiography in the diagnosis of retinal arterial macroaneurysms associated with submacular and preretinal hemorrhages: a case series. Am J Ophthalmol. 2000; 129(1):33-7. DOI: 10.1016/s0002-9394(99)00337-2. View

14.

Rabb M, Gagliano D, Teske M . Retinal arterial macroaneurysms. Surv Ophthalmol. 1988; 33(2):73-96. DOI: 10.1016/0039-6257(88)90160-9. View

15.

Rosenfeld P, Brown D, Heier J, Boyer D, Kaiser P, Chung C . Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355(14):1419-31. DOI: 10.1056/NEJMoa054481. View

16.

Moosavi R, Fong K, Chopdar A . Retinal artery macroaneurysms: clinical and fluorescein angiographic features in 34 patients. Eye (Lond). 2005; 20(9):1011-20. DOI: 10.1038/sj.eye.6702068. View

17.

Battaglia Parodi M, Iacono P, Ravalico G, Bandello F . Subthreshold laser treatment for retinal arterial macroaneurysm. Br J Ophthalmol. 2010; 95(4):534-8. DOI: 10.1136/bjo.2009.175547. View

18.

Chun D, Heier J, Topping T, Duker J, Bankert J . A pilot study of multiple intravitreal injections of ranibizumab in patients with center-involving clinically significant diabetic macular edema. Ophthalmology. 2006; 113(10):1706-12. DOI: 10.1016/j.ophtha.2006.04.033. View

19.

Pichi F, Morara M, Torrazza C, Manzi G, Alkabes M, Balducci N . Intravitreal bevacizumab for macular complications from retinal arterial macroaneurysms. Am J Ophthalmol. 2012; 155(2):287-294.e1. DOI: 10.1016/j.ajo.2012.07.029. View

20.

Fichte C, Streeten B, Friedman A . A histopathologic study of retinal arterial aneurysms. Am J Ophthalmol. 1978; 85(4):509-18. DOI: 10.1016/s0002-9394(14)75249-3. View