Indocyanine green angiography in the diagnosis of retinal arterial macroaneurysms associated with submacular and preretinal hemorrhages: a case series

PURPOSE: To report the use of indocyanine green angiography in the diagnosis of retinal arterial macroaneurysms associated with preretinal and subretinal hemorrhage. METHODS: Retrospective case series. Indocyanine green angiograms of five consecutive patients with dense preretinal, intraretinal, and subretinal hemorrhages in which the cause of hemorrhage was still in question after clinical evaluation and fluorescein angiography. RESULTS: In five eyes of five patients, indocyanine green angiography demonstrated acquired retinal arterial macroaneurysms as the cause of hemorrhage. Each diagnosis was confirmed after the hemorrhages spontaneously resolved or were surgically removed. CONCLUSIONS: Indocyanine green angiography is useful in the diagnosis of acquired retinal arterial macroaneurysms when fluorescein angiography is inconclusive because of preretinal, intraretinal, or subretinal hemorrhage. Establishing the diagnosis of retinal arterial macroaneurysm can influence the management of patients with submacular and premacular hemorrhage.