RETINAL ARTERIOLAR MACROANEURYSMS - LONG-TERM VISUAL OUTCOME

Visual outcome was analysed in 16 consecutive eyes with symptomatic re tinal arteriolar macroaneurysms treated by direct laser photocoagulati on and 26 consecutive symptomatic eyes followed with no treatment. No difference existed between groups in presenting visual acuity, macular involvement, presence of macular subretinal fluid, or presence or loc ation of associated haemorrhage. The mean follow up was 41 months. In the 26 untreated eyes, visual acuity was improved by 2 or more lines i n 13 (50%), was unchanged in nine (35%), and decreased in four cases ( 15%). In the 16 treated cases, three improved (19%), seven were unchan ged (43%), and six had decreased visual acuity (38%). The average mini mum angle of resolution improved 0.53 log units in untreated cases and decreased 0.14 log units in treated cases (p=0.02), Multivariable log istic regression modelling analysis revealed that laser treatment rema ined a significant risk factor for final visual acuity of less than 20 /80 even when controlling for the effects of subretinal haemorrhage an d foveal subretinal fluid (odds ratio 8.4, p=0.01). Laser photocoagula tion directly to the macroaneurysm did not improve the visual outcome in this series.