Spontaneous Rupture of a Macroaneurysm

An 80-year-old white woman was referred with a diagnosis of arterial macroaneurysm by her ophthalmologist for a fluorescein angiogram of the left eye.

A preinjection red-free image shows preretinal hemorrhages over the macroaneurysm (upper left).

Approximately three seconds postinjection, this arterial macroaneurysm ruptured spontaneously.

The early arterial phase of the fluorescein angiogram shows an explosive hyperfluorescence emanating from this macroaneurysm with blood flow screen of hypofluorescence extending down along the optic nerve and the macula (upper right). At 25 seconds postinjection, a more striking flow of sodium fluorescein and blood is seen (lower left). As the study progresses significant leakage of fluorescein and blood is documented during the recirculation phase (lower right).