Vitreous and Retina

Juxtafoveal Telangiectasia

Idiopathic juxtafoveal telangiectasia type 2 demonstrating abnormal foveal reflex with a slight graying of juxtafoveal retina temporally in the right eye and intraretinal hemorrhages in the left eye.
  • A condition that is characterized by exudation or diffusion abnormalities from ectatic (dilated and tortuous blood vessels) and incompetent retinal capillaries in the juxtafoveolar region
  • Can be found as a developmental or congenital vascular anomaly or an acquired condition.

Clinical Features

  • Symptoms: decreased vision secondary to serous exudation, macular edema or hard exudates in areas adjacent to the telangiectasis
  • These patients fall into several subgroups. Generally the entity has been subdivided into 3 groups:
    • Group 1: unilateral parafoveal telangiectasis, congenital or acquired
      • Typically occurs in males
      • Yellow, lipid-rich exudation is usually present at the outer margins of the area of telangiectasis forming circinate-type exudate
    • Group 2: Bilateral parafoveal telangiectasis
      • Occurs in either males or females
      • Usually have bilateral retinal thickening
      • Blunted right-angle venules, superficial retinal crystals, intraretinal pigment plaques, and subretinal neovascularization are common findings
    • Group 3: Bilateral perifoveal telangiectasis with retinal capillary obliteration
      • Progressive loss of vision from the obliteration of the perifoveal capillaries
      • Associated with a variety of systemic diseases including polycythemia, hypoglycemia, ulcerative colitis, multiple myeloma and chronic lymphatic leukemia

Management

  • Early laser photocoagulation maybe helpful in restoring and preserving central acuity for group 1
  • Group 2 and 3 typically do not respond to photocoagulation
  • Treatment of neovascularization when it develops in group 2