Macroaneurysm on the Optic Disc in a Patient with Aortic Dissection
A 60-year-old female who experienced deteriorated vision in her right eye the previous week visited our hospital. Best-corrected visual acuity in her right eye was limited to hand motion, her intraocular pressure was 15 mm Hg, the lens showed mild cataract, and the fundus was invisible due to vitreous hemorrhage. B-mode echography showed no retinal detachment, but there was mass refraction on the optic disc (fig. ). Vitrectomy combined with lens extraction by phacoemulsification and artificial intraocular lens implantation was performed. After removing the vitreous hemorrhage, a large macroaneurysm appeared on the optic disc (fig. ). The macroaneurysm was beating and oozing blood, but no other abnormal finding was observed. The aneurysm was not treated, and the oozing of blood from the macroaneurysm continued after surgery. Three weeks after surgery, however, the vitreous hemorrhage disappeared, and the patient's best-corrected visual acuity in the right eye increased to 1.0. The macroaneurysm gradually shrunk, and the oozing of blood and beating disappeared. The fundus photograph made 3 months after surgery is shown below (fig. ).\nOur patient started medication for hypertension at the age of 41 and kept her hypertension under control. She did not have hyperlipidemia, but she developed acute Stanford type A aortic dissection at the age of 51 (fig. ) and underwent synthetic graft replacement surgery. Marfan-like phenotype was not found. A contrast-enhanced computed tomography scan of the head showed no intracranial aneurysm (data not shown). Currently, the patient still has false lumen, but it did not progress after surgery.\nAt the age of 57, she started glaucoma eye drops (latanoprost) in both eyes at an ophthalmic clinic.