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Nonsurgical Management of Macular Hemorrhage Secondary to Retinal Artery Macroaneurysms
Cathleen M. McCabe, MD;
Harry W. Flynn, Jr, MD;
Walter C. McLean, MD;
Roy D. Brod, MD;
H. Richard McDonald, MD;
Mark W. Johnson, MD;
George A. Williams, MD;
William F. Mieler, MD;
for the Macroaneurysm Study Group
Arch Ophthalmol. 2000;118:780-785.
Objective To report visual acuity outcomes of nonsurgical management of macular hemorrhage secondary to retinal artery macroaneurysms.
Methods Forty-one patients at multiple centers with macular hemorrhage secondary to retinal artery macroaneurysms managed with observation alone were reviewed. Time to clearance of macular hemorrhage, visual acuity at final follow-up, and presence or absence of macular pigmentary changes after absorption of the hemorrhage were recorded for each patient.
Results On initial examination, visual acuity was 20/200 or worse in all except 4 patients (3 with 20/70, 1 with 20/80). At an average follow-up of 15.7 months, a final visual acuity of 20/40 or better was achieved in 15 eyes (37%), between 20/50 and 20/100 in 12 (29%), and 20/200 or worse in 14 (34%). Macular pigmentary abnormalities were noted after clearance of the hemorrhage in 23 (56%) of 41 cases, and these eyes generally had worse visual acuity outcomes.
Conclusions In eyes with macular hemorrhage secondary to retinal artery macroaneurysms managed with observation alone, good visual acuity outcomes can often be achieved. Poorer visual acuity outcomes are associated with macular pigmentary changes after resorption of blood.
From the Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla (Drs McCabe and Flynn); Departments of Ophthalmology, Pennsylvania State Medical Center, Hershey (Dr Brod), University of California, San Francisco (Dr McDonald), and University of Michigan, Ann Arbor (Dr Johnson); and The Eye Institute, Medical College of Wisconsin, Milwaukee (Dr Mieler). Dr McLean is in private practice in Ashville, NC, and Dr Williams, in Royal Oak, Mich.
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