Macroaneurysms of the retinal arteries.

In a study of the natural course and risk factors leading to visual impairment from retinal arterial macroaneurysms in 40 eyes (35 patients), we used a simple classification based on the anatomic location of the macroaneurysm and complicating factors. Group A included 17 eyes in which the exudate, edema, hemorrhage, or aneurysm (or a combination of these) was located within the vascular arcades and caused a decrease in central visual acuity. Group B included eight eyes in which the exudate, edema, hemorrhage, or aneurysm (or a combination of these) was located within the vascular arcades but did not cause a decrease in central visual acuity. Group C included 15 eyes in which the exudate, edema, hemorrhage, or aneurysm (or a combination of these) was located peripheral to the vascular arcades. Eyes in Group A with recent visual symptom had an uncertain prognosis and some were treated; eyes in Group B had a more favorable prognosis but required careful periodic examinations; and eyes in Group C had a favorable prognosis and almost always did well without treatment. Eyes with macroaneurysms hemorrhaging into the vitreous or under the inner limiting lamina also tended to recover.