I am 40 year old male who was recently diagnosed with microaneurysm in my right eye. My doctor immediately pointed out that diabetes is the most probable cause of this eye condition, but so far tests for diabetes have been negative. What else can cause a microaneurysm? Is it a sign of some other ongoing illness?

Let me start by saying that microaneurysms (MA’s) are very small although easily seen by the experienced. It is possible that if one does not see MA’s often, depending on the doctors patient population, that a “spot” may appear to be an MA, but is not. Secondly, MA’s are considered to be an indicator of diabetes although they may occur in other conditions that are related to poor oxygenation of the retinal tissue. Diabetes is a microvascular disease that in time causes poor blood circulation and ultimate tissue hypoxia that leads to various retinal signs such as dot hemorrhages and MA’s.

Other diseases that cause small vessel obstruction can have MA’s develop like vessel occlusions from hypertension. Hypoxia from carotid occlusive disease can give rise to MA’s. The list is short for conditions causing MA’s. MA’s are typically associated with diabetes and are outpouchings in the capillary walls usually seen were there are areas of oxygen deprivation. The outpouchings are the result of weakening vessel integrity due to the cascade of biochemical events secondary to elevated blood sugar.

The only study that I am aware of is the Diabetic Retinopathy and the Early Treatment Diabetic Retinopathy Study. These studies established that laser intervention at the appropriate time reduces the risk of severe vision loss by 50% in patients with proliferative retinopathy or clinically significant macular edema.

It is important to understand that laser treatment is intended to prevent blindness not restore or improve vision. Some patients may see less after the treatment but if they did not have the treatment they could progress to severe vision loss and be legally blind.

CAG