{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:54:51Z","timestamp":1765212891912,"version":"3.46.0"},"reference-count":31,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: We propose a flow-signal-based classification of retinal artery macroaneurysms (RAMs) using Optical Coherence Tomography Angiography (OCTA) and compare the findings with fundus fluorescein angiography (FFA). Methods: A retrospective review of 49 RAM cases observed over 6 years (October 2017\u2013March 2023) at a medical retina clinic at the University Hospital Southampton, UK. Electronic clinical records, FFA, and OCTA images (en face and B-scan) were reviewed to identify pathology and assess RAM flow profiles. Results: In total, 30 eyes from 30 patients were included. The mean age of the patients was 76 years (range 49\u201391), with 17 females and 13 males. All eyes underwent OCTA, enabling classification of RAMs into three flow signal types: high (9 eyes), low (10 eyes), and absent (9 eyes), while 2 eyes had haemorrhage-related artefacts. A subgroup of 13 eyes also underwent FFA, allowing direct comparison, which showed flow profiles similar to those of OCTA: high (4 eyes), low (6 eyes), and absent (2 eyes), with 1 ungradable case due to subretinal haemorrhage masking. A discrepancy in flow was observed in one case where FFA indicated flow, but OCTA did not. Despite this, FFA and OCTA generally agreed on the flow levels, with a Spearman correlation of r = 0.79 (p = 0.004). Conclusions: OCTA flow profiles were directly comparable to FFA. OCTA effectively identified different levels of blood flow signal behaviour in RAMs. The proposed flow-based RAM classification may aid in prognosis, treatment indications, follow-up, and safe repeat imaging in clinical practice without systemic risk to the patient.<\/jats:p>","DOI":"10.3390\/jcm14248686","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8686","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optical Coherence Tomography Angiography Features and Flow-Based Classification of Retinal Artery Macroaneurysms"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6290-0368","authenticated-orcid":false,"given":"Mohamed","family":"Oshallah","sequence":"first","affiliation":[{"name":"Ophthalmology Department, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-635X","authenticated-orcid":false,"given":"Anastasios E.","family":"Sepetis","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2834-6142","authenticated-orcid":false,"given":"Antonio","family":"Valastro","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eslam","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6125-5486","authenticated-orcid":false,"given":"Sara","family":"Vaz-Pereira","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculdade de Medicina, Universidade de Lisboa, 1649-004 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3182-557X","authenticated-orcid":false,"given":"Luca","family":"Ventre","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1185-6942","authenticated-orcid":false,"given":"Gabriella","family":"De Salvo","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK"},{"name":"Clincal and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.5301\/ejo.5000641","article-title":"Retinal arterial macroaneurysms: Clinical, angiographic, and tomographic description and therapeutic management of a series of 14 cases","volume":"26","author":"Cahuzac","year":"2016","journal-title":"Eur. J. 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