Retinal arterial macroaneurysm with blood-staining of the internal limiting membrane and optic nerve

An 83-year-old man presented with a retinal arterial macroaneurysm complicated by vitreous hemorrhage, hyphema and ghost cell glaucoma requiring surgical intervention. After pars plana vitrectomy, anterior chamber wash-out and laser photocoagulation, the retinal arterial macroaneurysm closed but blood-staining of the optic nerve, internal limiting membrane and peripapillary vessels persisted. The rare sequela of blood-staining, which in this case did not adversely affect the final visual outcome, further contributes to our understanding of the wide ranging clinical spectrum of retinal arterial macroaneurysms.