gms | German Medical Science

Macular disorders, especially anomalies of the vessels in this area, can cause diagnostic difficulties.

The 41-year-old woman was referred to our department with reduced visual acuity on one eye. One year before she had noticed a short-term visual disorder, but at that time clinical examination did not reveal any pathologic signs.

The visual acuity was reduced to 0.6, now with metamorphopsia. A small ectatic vessel with a surrounding edema was visible below the fovea. Hard exsudates were located at the border of the edema. A whitish preretinal structure with radial arranged retinal folds emerging from the center was situated nasally of the fovea. Upon indiocyanin green angiography an aneurysm was visible below the fovea and radial vessels appeared within the papillomacular bundle. In the late phase there was leakage. One year later, the edema and the hard exsudates had resolved spontaneously. The visual acuity increased to 0.8. There was only a subtle staining of the macroaneurysm below the fovea and angiographically visible leakage in the late phase. The other eye had a visual acuity of 1.25 and showed no abnormalities.

This vascular abnormality appeared spontaneously and presented as an angiomatosis retinae combined with a macroaneurysm. The blood-flow of the latter decreased spontaneously without treatment. Alternatively, a combination of an angiomatosis retinae and a polypoidal choroidal vasculopathy was taken into account. However, both vascular abnormalities were perfused through retinal vessels.