Juxtafoveal Retinal Arterial Macroaneurysm Diagnosed on Ancillary Imaging.

To describe a case of retinal arterial macroaneurysm, a rare, focal arterial dilatation that is commonly found temporally within the first 3 orders of retinal arterial bifurcations. An observational case report was evaluated. A 49-year-old man with prediabetes and hypercholesteremia presented with decreasing vision and a paracentral scotoma in the right eye. His ocular history was insignificant. There was significant intraretinal and subretinal fluid with perifoveal exudates. After 2 intravitreal injections of aflibercept for a tentative diagnosis of branch retinal vein occlusion, there was no improvement. Intravenous fluorescein angiography showed a small retinal arterial macroaneurysm less than 60 µm from the foveal avascular zone that was treated with low-power focal laser photocoagulation. This resulted in complete resolution of the macular edema with significant improvement in visual acuity. This rare and successfully treated case of an exudative juxtafoveal retinal arterial macroaneurysm highlights the importance of multimodal imaging in establishing an accurate diagnosis.