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A retinal arterial macroaneurysm is an acquired retinal vascular abnormality, typically a solitary, round or fusiform aneurysm arising in one of the four major branch retinal arteries in the paramacular area. According to hospital‐based investigations, most patients in whom this pathological condition develops are in their sixth or seventh decade of life and have a history of systemic hypertension, ophthalmoscopic evidence of retinal arteriolar sclerosis or both. Visual loss is caused by exudation or bleeding from the aneurysm. Massive retinal bleeding from a ruptured aneurysm can be confined to the preretinal, intraretinal or subretinal space, or dispersed into the vitreous.1,2,3,4 Since most reports on retinal macroaneurysm arise from hospital‐based studies and because no information is available about the prevalence of retinal macroaneurysms, particularly in the Chinese population, this population‐based study was conducted.
The Beijing Eye Study is a population‐based cohort study in northern China, carried out in four communities from the Haidian urban district in the Northern part of central Beijing and in three communities from a rural district in the village area of Yufa (Daxing District) in the south of Beijing.5 The medical ethics committee of the Beijing Tongren Hospital, Beijing, China approved the study protocol, and all participants gave informed consent, according to the Declaration of Helsinki. At the time of the survey in the year 2001, there were 5324 individuals aged 40 years residing in these 7 communities. In all, 4439 individuals (2505 women) participated in the eye examination, corresponding to an overall response rate of 83.4%. This study included 8609 eyes of 4335 (97.7%) subjects for whom readable fundus photographs were available. Mean age was 56.0 (10.4) years (range 40–101 years), mean refractive error was −0.39 (2.24) D (range−20.13 to +7.50 D). The examinations performed during the study included colour photographs of the optic disc and macula.
Two retinal macroaneurysms were detected on the fundus photographs of one eye (prevalence rate per eye: 0.01% (0.01%) (mean (SE)); 95% CI 0.00% to 0.03%) of a female subject aged 67 years (prevalence rate per subject 0.02% (0.02%); 95% CI 0.00% to 0.07%). Visual acuity was hand movements due to marked macular oedema with pronounced deposition of hard exudates in the foveal region. One of the macroaneurysms was located superior to the fovea and inferior to the superior temporal vessel arcade leading to the foveal oedema; the other macroaneurysm was located nasally to the optic disc at a distance of about 1.5 mm. The intraocular pressure was 15 mm Hg. The contralateral eye showed a normal ophthalmoscopic appearance of the fundus.
The data suggest that retinal macroaneurysms may occur in about 1 of 9000 eyes or in approximately 1 of 4500 adult Chinese.
Competing interests: None.