case_images: PMC11249609_01
case_images: a Case 1: A 71-year-old woman. Color fundus photograph of the right eye on presentation (December 20, 2017) shows disappeared macular reflex. RAM is evident in the upper part of the vascular arcade (white arrow). b On fundus FA in the intermediate phase, numerous capillary aneurysms are evident. Fluorescein pooling in the retinal macroaneurysm is evident (white arrow). c Color fundus photography on January 20, 2020, shows the macular annular reflex. The RAM seen in the upper part on presentation has disappeared. d Fundus FA (January 20, 2020). The RAM evident on presentation has disappeared, and capillary aneurysms have also decreased. e After the first intravitreal injection of ranibizumab on January 9, 2018. OCT on January 23, 2018, shows serous retinal detachment in the macular area and edema of the outer layer of the retina in horizontal section. f After the fourth intravitreal injection of ranibizumab on April 19, 2018, OCT on May 1, 2018, shows a further decrease in serous retinal detachment in the macular area, and edema of the outer layer of the retina has disappeared. g After the five injections of ranibizumab and the second intravitreal injection of aflibercept on November 1, 2018, OCT on November 12, 2018, shows a further decrease in serous retinal detachment in the macular area. h After the five intravitreal injections of ranibizumab and the seventh intravitreal injection of aflibercept on December 2, 2019, OCT on January 20, 2020, shows that the serous retinal detachment in the macular area has kept disappearing, and visual acuity has improved to 0.7.
case_images: cop-2024-0015-0001-538998_F01.jpg
case_images: PMC11249609_01_cop-2024-0015-0001-538998_F01.jpg
case_images: F1
case_images: In the fundus, the macular annular reflex had disappeared, and RAM was evident in the upper part of the vascular arcade at a distance of two papillary diameters from the macular area (Fig. 1a). It was larger than the capillary aneurysm (Fig. 1b). Color fundus photograph on January 20, 2020, showed that the RAM seen in the upper part on presentation has disappeared (Fig. 1c). FA at a final follow-up on January 20, 2020, showed some residual macular edema, but the numerous capillary aneurysms that had been evident on initial examination had almost disappeared, along with the RAM (Fig. 1d). OCT after anti-VEGF injection showed decreasing of macula edema and serous retinal detachment (Fig. 1e-h). OCT on December 9, 2019, showed that macular edema had disappeared (Fig. 1h).
case_images: PMC11249609_02
case_images: a Case 2: an 81-year-old woman. On presentation, vitreous hemorrhage in the right eye means that the optic papilla is only dimly visible, and detailed observation of the fundus is impossible. Intravitreal injection of ranibizumab was administered on June 24, 2016. Fundus photography of the right eye on July 1, 2016. The fundus is clearly part of the vascular arcade which is evident. Retinal hemorrhage is apparent on the upper temporal side of the macular area. b Fundus FA. In the intermediate phase, fluorescence pooling (white arrow) is evident in the upper part. c OCT shows a fibrin mass in the macular area. d After intravitreal injection of ranibizumab into the right eye on July 29 and September 7, 2016, color fundus photography on June 7, 2017, shows that intraretinal hemorrhage in the vascular arcade and upper part of the macular has disappeared. e Fundus FA on the same day. Intravitreal hemorrhage has disappeared, and the aneurysm visible in (b) has been obliterated. f OCT on September 23, 2020. The fibrin mass in the macular area disappeared. Visual acuity has improved to 0.2.
case_images: cop-2024-0015-0001-538998_F02.jpg
case_images: PMC11249609_02_cop-2024-0015-0001-538998_F02.jpg
case_images: F2
case_images: Color fundus photography revealed hemorrhage in the macular area and intraretinal hemorrhage in the upper part of the vascular arcade (Fig. 2a). On FA, in the intermediate phase, the RAM was visible in a vessel in the upper part of the vascular arcade (Fig. 2b). On OCT, fibrin was evident in the macular area below and within the retina (Fig. 2c). The retinal hemorrhage in the upper macular area had also disappeared (Fig. 2d). On fundus FA, the RAM that had been visible on July 1, 2016, appeared to have been obliterated (Fig. 2e).