case_images: PMC8077541_01
case_images: Hemorrhagic RAM. a On the near-infrared reflectance image, the white arrow points to the hemorrhagic RAM along the first-order inferior temporal arteriole, and the black asterisk demonstrates preretinal hemorrhage. b SD-OCT at the level of the macroaneurysm shows a multilayered hemorrhage involving the sub-inner limiting membrane space (black asterisk) and the intraretinal space (black star). The reliability of the intraretinal layers is significantly affected by the presence of posterior shadowing (white asterisk). RAM, retinal arterial macroaneurysm; SD-OCT, spectral-domain optical coherence tomography.
case_images: cop-0012-0150-g01.jpg
case_images: PMC8077541_01_cop-0012-0150-g01.jpg
case_images: F1
case_images: Fundus examination of the OD showed signs of hypertensive retinopathy, including arteriolar constriction and arteriovenous nicking, whereas OS examination revealed a dome-shaped subhyaloidal premacular hemorrhage and a clear focal lesion corresponding to a RAM along the inferior temporal retinal arteriole (shown in Fig. 1a), which was associated with bleeding at the subretinal, intraretinal, and preretinal levels. Figure 1b shows that the SD-OCT demarcated the extent of preretinal and intraretinal bleeding.
case_images: a On NIR-R of the fundus taken 3 years before, the white arrowhead highlights a cuff-type thickening of the arteriolar vessel wall at the site of the current complicated retinal arterial macroaneurysm. b SD-OCT scan shows normal foveal depression and retinal thickness. NIR-R, near-infrared reflectance imaging; SD-OCT, spectral-domain optical coherence tomography.
case_images: cop-0012-0150-g02.jpg
case_images: PMC8077541_01_cop-0012-0150-g02.jpg
case_images: F2
case_images: NIR-R taken 3 years prior demonstrated a cuff-type thickening of the arteriolar vessel wall at the site of the current complicated RAM (shown in Fig. 2) that had gone completely unnoticed.