Retinal arterial macroaneurysms represent an acquired vascular irregularity that is primarily observed in the elderly population. The high variability surrounding the clinical presentation of this condition makes the initial diagnosis challenging. Employing several diagnostic techniques including fundus fluorescence angiography, indocyanine green angiography, optical coherence tomography, and optical coherence tomography angiography ensures that any hemorrhages secondary to macroaneurysms rupture are identified promptly.

Diagnosis of retinal arterial macroaneurysm must be confirmed by complimenting clinical examination with imaging techniques such as FFA, OCT, and indocyanine green angiography (ICGA)….It is recommended to conduct indocyanine green angiography (ICGA) in cases where the nature of macroaneurysm cannot be confirmed because of the obscurity of hemorrhage. RAMs show well-defined areas of hyper fluorescence with ICG angiography and ICG can pinpoint the exact location of the macroaneurysm in cases of dense hemorrhage, which may be useful in planning surgery or treatment .

This is crucial for appropriately managing the case and ensuring a good prognosis. 

https://www.cureus.com/articles/89147-multilayered-hemorrhage-secondary-to-retinal-arterial-macroaneurysm-rupture-a-case-report-and-review-of-literature

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