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Purpose <p>To evaluate the clinical outcomes of symptomatic exudative retinal arterial macroaneurysms (RAMs) following anti-vascular endothelial growth factor (anti-VEGF) therapy.</p> Methods <p>This retrospective study included treatment-naïve patients with exudative RAM who received anti-VEGF injections and were followed for ≥ 6 months. Clinical data and multimodal imaging findings, including optical coherence tomography angiography (OCTA), were analyzed.</p> Results <p>Thirty-seven eyes (37 patients) were included. The mean number of anti-VEGF injections was 2.4 ± 1.5 over a mean follow-up of 10.1 ± 4.3 months. BCVA, measured as the logarithm of the minimum angle of resolution (Snellen equivalent), improved significantly from 0.97 ± 0.42 (20/187) at baseline to 0.62 ± 0.36 (20/84) at the final visit (<i>P</i> &lt; 0.001). CST decreased from 548.3 ± 180.4&#xa0;μm to 285.8 ± 76.9&#xa0;μm (<i>P</i> &lt; 0.001). Baseline OCTA identified two morphologic types of RAMs: type 1 (distended, 68.3%) and type 2 (meshed, 31.7%). Both types exhibited reduced flow signals and shrank after treatment. B-scan OCTA revealed the absence of flow signals in RAM lesions in 22 eyes (59.5%) and complete resolution of macular edema in 32 eyes (86.5%). Subgroup analysis showed that type 1 RAMs required more anti-VEGF injections than type 2 RAMs (2.79 ± 1.59 vs. 1.69 ± 1.11, <i>P</i> = 0.03). Baseline BCVA was an independent predictor of final BCVA (<i>P</i> &lt; 0.001).</p> Conclusion <p>Intravitreal anti-VEGF therapy for exudative RAMs is associated with functional and anatomical improvement. OCTA-based morphologic classification may predict therapeutic response, with type 1 RAMs requiring a higher treatment burden.</p>

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Anti-VEGF therapy for symptomatic exudative retinal arterial macroaneurysms: functional and anatomic outcomes with OCTA findings

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Wenyi Tang,
  • Xin Yang,
  • Keyan Wang,
  • Min Wang,
  • Gezhi Xu,
  • Wei Liu

摘要

Purpose

To evaluate the clinical outcomes of symptomatic exudative retinal arterial macroaneurysms (RAMs) following anti-vascular endothelial growth factor (anti-VEGF) therapy.

Methods

This retrospective study included treatment-naïve patients with exudative RAM who received anti-VEGF injections and were followed for ≥ 6 months. Clinical data and multimodal imaging findings, including optical coherence tomography angiography (OCTA), were analyzed.

Results

Thirty-seven eyes (37 patients) were included. The mean number of anti-VEGF injections was 2.4 ± 1.5 over a mean follow-up of 10.1 ± 4.3 months. BCVA, measured as the logarithm of the minimum angle of resolution (Snellen equivalent), improved significantly from 0.97 ± 0.42 (20/187) at baseline to 0.62 ± 0.36 (20/84) at the final visit (P < 0.001). CST decreased from 548.3 ± 180.4 μm to 285.8 ± 76.9 μm (P < 0.001). Baseline OCTA identified two morphologic types of RAMs: type 1 (distended, 68.3%) and type 2 (meshed, 31.7%). Both types exhibited reduced flow signals and shrank after treatment. B-scan OCTA revealed the absence of flow signals in RAM lesions in 22 eyes (59.5%) and complete resolution of macular edema in 32 eyes (86.5%). Subgroup analysis showed that type 1 RAMs required more anti-VEGF injections than type 2 RAMs (2.79 ± 1.59 vs. 1.69 ± 1.11, P = 0.03). Baseline BCVA was an independent predictor of final BCVA (P < 0.001).

Conclusion

Intravitreal anti-VEGF therapy for exudative RAMs is associated with functional and anatomical improvement. OCTA-based morphologic classification may predict therapeutic response, with type 1 RAMs requiring a higher treatment burden.