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Retinal Arterial Macroaneurysm (RAM)

What is a retinal arterial macroaneurysm (RAM)?

A RAM is an uncommon weakening of the artery wall of a larger retinal blood vessel. It usually develops in older, hypertensive individuals. Patients can be totally asymptomatic or may develop sudden or gradual vision loss.

How is a RAM diagnosed?

A RAM is diagnosed during a careful dilated retinal examination. The RAM itself usually appears as a yellow round spot along the course of a retinal artery near the optic nerve or macula. Patients can present with macular blood or macular edema.


Normal macula


The RAM (arrow) has leaked blood into the macula

How is a RAM treated?

Macular blood will often resolve over several weeks to months of observation. However, depending on its extent and a patient’s symptoms, it can also be treated with either intravitreal injections (as are done for retinal vein occlusions) or laser photocoagulation. Symptomatic macular edema is almost always treated. The return of vision can be variable, with some recovering excellent vision and others developing permanent central vision loss.