First Author: E.Jin CHINA
Co Author(s): H. Qi M. Zhao
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We report two cases of foveal macroaneurysm with long-standing macular edema in a rare location those resistant to anti-VEGF agent, successfully treated with laser photocoagulation, to investigate the diagnose and treatment strategy for foveal exudative macroaneurysm in a rare location.
Two patients were diagnosed as retinal macroaneurysm, localized about 350-500 μm from the centre of the fovea, with fluorescein angiography, indocyanine green angiography and optical coherence tomography. The best-corrected visual acuity(BCVA) and morphological data of them treated with monthly ranibizumab intravitreal injections and laser photocoagulation were evaluated by optical coherence tomography and fluorescein angiography.
Case 1 was a 57-year-old man, got no BCVA improved with 5 monthly ranibizumab intravitreal injection, and from 2/10 to 6/10 after the laser photocoagulation treatment. The central retinal thickness was evaluated by optical coherence tomography and improved from 463 to 212 μm, with the resolution of both the associated serous detachments and the cystoid macular edema. Case 2 was a 47-year-old man, got no BCVA improved with 3 monthly ranibizumab intravitreal injection, and from 2/10 to 2.5/10 after the laser photocoagulation treatment. The macroaneurysm lumen completely collapsed with the treatment of small spot laser photocoagulation.
Laser photocoagulation may be an effective choice for the treatment of long-standing macular edema associated with foveal macroaneurysms that unresponsive to anti-VEGF treatment.