Laser Treatment for Retinal Arterial Macroaneurysm

Retinal arterial macroaneurysm (RAM) can be defined as an acquired round or fusiform dilation of a retinal artery. RAMs frequently remain stable but, in some cases, can complicate with macular exudation or hemorrhage, resulting in symptomatic disease. While a watch-and-wait approach is the standard option in asymptomatic RAMs, there is no universal agreement regarding treatment of symptomatic cases and randomized clinical trials are warranted. Anti-VEGF intravitreal injections can reduce exudation, albeit multiple treatments may be necessary. Hence, laser treatment may be a better choice to provide a durable control of symptoms while anti-VEGF therapy should be preferred for lesions adjacent to the fovea. Indirect laser is recommended because there is a decreased danger of RAM rupture and hemorrhage. Furthermore, subthreshold laser seems to be comparable to conventional laser in terms of efficacy outcomes