Congenital Anomalous Retinal Artery Associated With a Leaking Macroaneurysm

Report of a Case. A 71-year-old man was referred to the retina service for “bleeding behind the right eye.” His medical history was significant for ischemic heart disease, hypertension, and emphysema. He was using anitglaucoma medication. On examination, his best-corrected visual acuity was counting fingers at 4 m OD and 20/50 OS. Results of anterior segment evaluation were unremarkable, with normal intraocular pressure. Ophthalmoscopy of the right eye revealed an aberrant artery that extended from the inferior temporal arcade (Figure 1), crossed the macula, and was associated with a macroaneurysm, subretinal hemorrhage, and macular edema. The posterior segment of the left eye was normal (Figure 1, insert). Fluorescein angiography confirmed the presence of the anomalous inferior temporal branch along with a leaking macroaneurysm in the macular area (Figure 2). There was evidence of early filling and late emptying of the aneurysm (Figure 2). Because of macular involvement, the patient underwent focal photocoagulation (532-nm green laser). Six weeks following treatment, his visual acuity improved to 20/100 OD.