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Natural Course of Ruptured Retinal Arterial Macroaneurysm

      A 70-year-old woman experienced sudden-onset blurry vision in her left eye, with a decrease in visual acuity to counting fingers. Examination revealed a ruptured retinal arterial macroaneurysm with retinal and sub-internal limiting membrane (ILM) hemorrhages (A). OCT (inset) demonstrated sub-ILM hyperreflectivity. Continuous resolution of sub-ILM hemorrhage was identified at 2, 6, 14, and 22 weeks, and at 1 year (B-F). Hard exudates developed (D) and resolved at 1-year follow-up. OCT (inset) demonstrated ILM detachment. The retinal arterial macroaneurysm became fibrotic, and the final best-corrected visual acuity was 20/25.
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