Tactics of treatment for patients with retinal arterial macro-aneurysm

To present clinical cases of retinal arterial macro- aneurysms with definition of features of clinical course and tactics of its treatment. The medical records of 12 patients which were observed and operated on retinal arterial macro-aneurysms at our clinic between 2012 and 2013 were analyzed. All patients underwent a complete ophthalmic examination, including optical coherence tomography of retina and fluorescein angiography. According to clinical course, patients were divided into four groups: asymptomatic form -3, hemorrhagic form -2 and exudative form of macro-aneurysm -6, as well as 1 ruptured macro-aneurysm was defined as a separate group. Patients were examined in dynamic follow-up every second day and 3, 6, 9 months after the surgery. Negative dynamics was not observed in 2 patients in the Group 1, one patient required laser coagulation of macro-aneurysm, due to an increased edema of the macular area. In the second group the patients underwent a combined surgery of macro-aneurysm laser coagulation and hyaloid puncture. Postoperative complications were not found, visual acuity was high. The combined laser coagulation was performed in patients with the exudative form of macro-aneurysm course and, if necessary. macular barrage. The positive dynamics was noted in 5 cases. Intravitreal Lucentis was injected to the patient of the group 4 as a first step, and barrage of macular area was made as the second step. In the postoperative period a complete resorption of hard exudates and an improvement in visual acuity were noted. The choice of treatment method of retinal arterial macro-aneurysm depends on the form of the course, localization of macro-aneurysms, complications and their duration.