Microaneurysm

Microaneurysm

A microaneurysm is a small, localized outpouching or dilation of a blood vessel, typically a capillary, that occurs due to weakness in the vessel wall. Microaneurysms are most commonly associated with the retina and are a hallmark of diabetic retinopathy, a complication of diabetes mellitus.

Pathophysiology

Microaneurysms form when the pericytes, which are contractile cells that wrap around the endothelial cells of capillaries and venules, are damaged or lost. This damage is often due to chronic hyperglycemia in diabetes, leading to increased vascular permeability and leakage. The loss of pericytes results in the weakening of the capillary walls, causing them to bulge and form microaneurysms.

Clinical Significance

Microaneurysms are the earliest clinically visible sign of diabetic retinopathy and can be detected during a fundoscopic examination. They appear as small, red dots on the retina and are often the first indication of retinal vascular damage. Over time, microaneurysms can rupture, leading to retinal hemorrhages and further complications such as macular edema and proliferative diabetic retinopathy.

Diagnosis

Microaneurysms are typically diagnosed through retinal imaging techniques such as fluorescein angiography and optical coherence tomography (OCT). Fluorescein angiography involves the injection of a fluorescent dye into the bloodstream, which highlights the retinal blood vessels and allows for the identification of microaneurysms and other vascular abnormalities.

Management

The management of microaneurysms primarily involves controlling the underlying cause, such as maintaining optimal blood glucose levels in diabetic patients. Regular monitoring of retinal health through eye examinations is crucial. In some cases, laser photocoagulation therapy may be used to seal leaking microaneurysms and prevent further retinal damage.

Also see

• Diabetic Retinopathy
• Retinal Hemorrhage
• Macular Edema
• Fluorescein Angiography
• Optical Coherence Tomography