Natural history of an optic disk macroaneurysm

Abstract

Case report

A 75-year old man with reduced vision in his left eye (0.05) presented with hypertensive retinopathy, retinal hemorrhages and cotton wool spots in the papillomacular bundle, as well as macular edema. Fluorescein angiography showed a saccular hyperfluorescent lesion corresponding to arterial macroaneurysm on the optic disk, with the optical coherence tomography demonstrating macular edema. At 2 months follow-up, vision had improved to 0.7 with spontaneous closure of the macroaneurysm and resolution of the macular edema.

Discussion

Arterial macroaneurysms on the optic disk are unusual and are difficult to diagnose clinically. There is no safe and effective treatment, and our case, as the few single cases reported, showed that they can spontaneously close and enable visual function to recover.

Resumen

Caso clínico

Varón de 76 años con agudeza visual (AV) de 0,05, que presentaba retinopatía hipertensiva, con hemorragias y manchas algodonosas en haz papilomacular y edema macular. La angiografía fluoresceínica mostró una dilatación sacular hiperfluorescente arterial correspondiente con un macroaneurisma papilar y la tomografía de coherencia óptica (OCT), edema macular. A los 2 meses, la AV mejoró a 0,7, con cierre espontáneo del macroaneurisma y resolución del edema macular.

Discusión

Los macroaneurismas papilares son infrecuentes y presentan dificultades en su diagnóstico. No existe ningún tratamiento seguro y eficaz y, en concordancia con los pocos casos publicados, la involución espontánea permite la recuperación visual.