Retinal arterial macro-aneurysm as a clue to increased hypertension

Abstract Retinal arterial macro-aneurysm (RAM) is an acquired focal aneurysmal dilation of an arteriole, usually within the first 3 orders of the retinal arterial system. Retinopathy is a common complication of systemic hypertension and atherosclerotic vascular disease as de-scribed by Keith et al. The most important risk factors for RAM are chronic systemic hypertension (75% of patients), arteriosclerosis, abnormal lipid levels, and inherent structural defects in blood vessels. Lavin and colleagues classified RAM into 3 clinical forms: quiescent, hemorrhagic, and exudative. This includes a complete clinical examination including fundus examination aided by routine examinations such as blood pressure measurement and lipid profile to assess systemic associations and imaging studies such as FFA,ICGA,OCT,OCT-A.Hypertensive patients with RAM should be referred to their primary care physician to optimize blood pressure control. Management of the ocular manifestations of RAM depends on the visual acuity in the affected eye, as well as the location of the lesion and associated consequences.