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Clinical characteristics of retinal arterial macroaneurysms and prognosis of different interventions

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To estimate the clinical characteristics of retinal arterial macroaneurysms (RAM) and evaluate the prognosis of different interventions.

Methods

This study is a meta-analysis. The databases PubMed, EMBASE, and Ovid from inception to January 2021 were searched to identify the relevant studies. R software version 3.6.3 was used to perform the statistical analyses. Results in proportion with 95% confidence interval were calculated by means of Freeman-Tukey variant of arcsine square transformation.

Results

Sixty-nine studies involving 1332 patients were finally included. The pooling results indicated that 91% (95% CI [88 ~ 94%]) of the RAM patients were over sixty, 73% (95% CI [68 ~ 77%]) were female, and 73% (95% CI [66 ~ 79%]) have hypertension. By observation, the RAM closure rate was 64% (95% CI [39 ~ 86%]), the visual acuity (VA) improved in 55% (95% CI [40 ~ 71%]) of the patients, and the VA of 64% (95% CI [54 ~ 74%]) hemorrhagic versus 27% (95% CI [15 ~ 41%]) exudative patients improved significantly. By laser, the closure rate was 96% (95% CI [87 ~ 100%]), the VA improved in 73% (95% CI [65 ~ 80%]) of the patients, and the VA of 66% (95% CI [47 ~ 84%]) hemorrhagic versus 35% (95% CI [23 ~ 47%]) exudative patients improved significantly. By anti-VEGF, the closure rate was 98% (95% CI [93 ~ 100%]), the VA improved in 90% (95% CI [74 ~ 100%]) of the patients, and the VA of 58% (95% CI [18 ~ 94%]) hemorrhagic versus 67% (95% CI [31 ~ 96%]) exudative patients improved significantly.

Conclusion

RAM are most commonly seen in the elderly with a marked female predominance and a strong association with hypertension. Patients receiving laser or anti-VEGF treatments get higher closure rate and better visual prognosis than those with observation alone. Hemorrhagic RAM have a better visual prognosis by observation or laser treatment, while exudative RAM have a better visual prognosis by anti-VEGF treatment.

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Availability of data and material

The datasets presented in this study are available from the corresponding author upon request.

Code availability

Not applicable.

Abbreviations

RAM:

Retinal arterial macroaneurysms

VEGF:

Vascular endothelial growth factor

ST:

Superotemporal

IT:

Inferotemporal

SILMH:

Subinternal limiting membrane hemorrhage

IRH:

Intraretinal hemorrhage

SRH:

Subretinal hemorrhage

VA:

Visual acuity

PPV:

Pars plana vitrectomy

YAG:

Yttrium aluminum garnet

tPA:

Tissue plasminogen activator

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Funding

This work is supported by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2018PT32029).

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Authors and Affiliations

  1. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

    He Chen, Xin-yu Zhao, Li-hui Meng, Wen-fei Zhang & You-xin Chen

  2. Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    He Chen, Xin-yu Zhao, Li-hui Meng, Wen-fei Zhang & You-xin Chen

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  1. He Chen
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Contributions

He Chen carried out the literature search and data extraction, and drafted the manuscript. Xin-yu Zhao devised this study and contributed to statistical analysis and revision of the manuscript. You-xin Chen coordinated and participated in the entire process of drafting and revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xin-yu Zhao.

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Chen, H., Zhao, Xy., Meng, Lh. et al. Clinical characteristics of retinal arterial macroaneurysms and prognosis of different interventions. Graefes Arch Clin Exp Ophthalmol 260, 439–450 (2022). https://doi.org/10.1007/s00417-021-05364-0

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  • DOI: https://doi.org/10.1007/s00417-021-05364-0

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