LARGE RETINAL CAPILLARY ANEURYSM: Clinical Features, Multimodal Imaging Characteristics, and Treatment Outcomes of Primary and Secondary Lesions.

PURPOSE: To compare the clinical features, multimodal imaging characteristics, and treatment outcomes of primary and secondary large retinal capillary aneurysms (LRCAs).

METHODS

A total of 34 eyes were included: seven with primary LRCA and 27 with secondary LRCA. All patients underwent fundus photography, optical coherence tomography (OCT), and fundus fluorescein angiography. Indocyanine green angiography and OCT-angiography were performed in selected cases. Various clinical, morphologic, and vascular features and treatment outcomes were evaluated and compared between the primary and secondary LRCA groups.

RESULTS

All lesions in the primary LRCA group were unilateral, and five of seven were unifocal. However, in the secondary LRCA group, 19% of patients had bilateral involvement and lesions were multifocal in 48% of eyes. OCT characteristics, including the horizontal and vertical diameters of aneurysmal lesions and mean subfoveal choroidal thickness, were similar for the groups ( P > 0.05). During follow-up, neither visual acuity nor central macular thickness changed significantly in the primary LRCA group and no cases responded to treatment, whereas these improved significantly in the secondary LRCA group.

CONCLUSION

Clinical and imaging characteristics of primary and secondary LRCA lesions were similar, although treatment outcomes were more favorable in secondary LRCA lesions because of the differing pathophysiology and etiology.