Intraretinal Macroaneurysms and Multimodal Imaging: A Retrospective Analysis

PURPOSE: To analyze the multimodal imaging characteristics of intraretinal macroaneurysms. PATIENTS AND METHODS: Intraretinal aneurysms larger than 150 μm in diameter on fluorescein angiography were termed as intraretinal macroaneurysm and grouped as primary and secondary according to the absence or presence of any coexisting posterior segment diseases. RESULTS: A total of 20 intraretinal macroaneurysms were observed in 18 eyes of 18 patients. Mean age of the cohort was 65.44 ± 9.14 years (Range; 49–82 years). Mean diameters of intraretinal macroaneurysms were 238.20 ± 61.12 μm (Range; 163.00–292.50 μm) and 242.72 ± 49.58 μm (Range; 168.00–328.00 μm) on fluorescein angiography and optical coherence tomography, respectively. Primary group had 10 eyes with 11 intraretinal macroaneurysms, whereas eight eyes had nine intraretinal macroaneurysms in the secondary group. Three of the eight eyes (37.5%) had diabetic retinopathy, four (50%), retinal vein occlusion, and one (12.5%), posterior uveitis in the secondary group. No statistically significant differences were found between the two groups in terms of age, sex, presence of intraretinal or subretinal fluid, the mean age, the mean central macular thickness, the mean distance of intraretinal macroaneurysms from the fovea, the mean diameter of intraretinal macroaneurysms measured on fluorescein angiography, and the mean diameter of intraretinal macroaneurysms measured on optical coherence tomography. Presence of intraretinal fluid was significantly more frequent than the presence of subretinal fluid in all eyes (p = 0.004). CONCLUSION: Intraretinal macroaneurysms are diagnosed more and more with the utilization of multimodal imaging techniques. We propose a simple classification system in order to help achieving a standardized terminology and ensure consistent understanding. The classification can be simplified as primary or secondary intraretinal macroaneurysm according to the absence or presence of the associated posterior segment disorders.