Retinal artery macroaneurysm (RAM) is a rare, acquired, round or fusiform dilation of the retinal arteriole, most commonly found along the temporal arcades.¹,²,³,⁴

RAM is most commonly associated with hypertension and arteriosclerotic disease,¹,² and in one-third of cases, it is associated with retinal vein occlusion.³

It is more prevalent among females and occurs unilaterally in 90% of cases.¹

Diagnosis is made based on clinical examination and fluorescein angiography. Associated signs of aneurysmal rupture include edema, hemorrhage, and exudation, often in a circinate pattern surrounding the aneurysm (Figure 14.1A).¹

On fluorescein angiography (FA), RAM is characterized by early uniform filling of the dilated arteriole.¹ Incomplete or absent filling can be seen in thrombosed or involuted macroaneuryms.¹,³