Comments and Conclusion (Cont’d)

  • High blood pressure is a risk factor for developing arterial macroaneuryrns (MAs) and 75% of patients with MAs have been diagnosed with hypertension. Women over the age of 40 are also at an increased risk for developing MAs due to hormonal and heritable causes. Our patient (Case 3), a 70-year-old female with hypertension, falls within both categories for increased risk of MAs.4
  • Aging of the arteries leads to replacement of flexible smooth muscle with collagen which reduces the elasticity of the arterial walls. A patient with hypertension already has an increased hydrostatic pressure within the arterial walls, so the decreased elasticity due to aging increases the likelihood of developing MAs.4
  • The patient in Case 4 has an advanced stage of IRVAN, which has been recently classified into 5 different stages based on ocular findings. Based on one study, treatment during stages 1-3 had a much better prognosis than those treated at the later stages 4 and 5. Patients treated during stages 1-3 often retained 20/20 VA, while those treated in stages 4 and 5 often progressed to 20/200 or worse.5