1/15. Histopathologic study of presumed parafoveal telangiectasis.PURPOSE: To report the postmortem histopathologic features that closely resemble the clinical features of parafoveal telangiectasis. methods: light and electron microscopy. RESULTS: Histopathologic features included macular edema; telangiectatic vessels; retinal, subretinal, and superficial retinal neovascularization; retinal pigment epithelial hyperplasia around neovascular aggregates; retinal-choroidal vascular anastomosis; and superficial pigmented cells with lipofuscin. CONCLUSION: The postmortem histopathologic findings in a 36-year-old woman with down syndrome and other systemic conditions correlate with features noted in previous reports of presumed parafoveal telangiectasis.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/15. Familial spastic paraplegia and maculopathy with juxtafoveolar retinal telangiectasis and subretinal neovascularization.PURPOSE: To describe a previously unreported condition involving familial spastic paraplegia and a peculiar type of maculopathy. methods: Two pairs of siblings were studied. All four cases underwent serial clinical examinations, fundus photography, and fluorescein angiography. Two siblings had extensive investigations. RESULTS: Characteristics of the four cases include spastic paraplegia diagnosed in the first decade of life and visual loss at about age 9 due to a maculopathy with an abnormal vascular complex. In the early stages, parafoveal dilatation of the capillary network was noted. The later stages were characterized by cystic macular degeneration, and seven of eight eyes developed fibrovascular scars with retinochoroidal anastomoses, pigment migration, and atrophic changes. In two siblings, electro-oculographic findings were subnormal, whereas results of electroretinography, magnetic resonance imaging of the brain and spinal cord, and metabolic and karyotype studies were normal. These siblings were an Indonesian girl and boy; the other siblings were white males. There was no consanguinity of the parents and family history was unremarkable. CONCLUSIONS: This study suggests that the two pairs of siblings have an identical familial and probably recessive disorder with neurodegenerative changes that have caused paraplegia and a peculiar maculopathy associated with anomalous retinal vascular complexes, retinochoroidal anastomoses, and subretinal neovascularization.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
3/15. Retinal angiopathy and polypoidal choroidal vasculopathy.PURPOSE: To describe the clinical and angiographic features of patients with polypoidal choroidal vasculopathy, exudative detachment of the macula, and an associated retinal microangiopathy. methods: Case series. RESULTS: Four patients with chronic exudative detachment of the macula with a variable degree of lipid deposition are described. The retina in the detached area, but not beyond, was noted to have a microangiopathy. There was capillary telangiectasia, microaneurysm formation, patchy nonperfusion, and intraretinal leakage. In each patient, there were no other retinal vascular changes in the fundus of either eye. The fluorescein angiogram showed subretinal leakage suspicious for occult choroidal neovascularization. The indocyanine green angiogram showed the presence of underlying polypoidal choroidal neovascularization, accounting for the exudative detachment. After photocoagulation, the retinal angiopathy improved, but not completely. CONCLUSION: Retinal microangiopathy may occur in a chronic macular detachment secondary to polypoidal choroidal neovascularization. The development of these secondary retinal changes is not clearly understood; however, hypoxia from the chronic detachment, a neurotoxic effect from the lipid deposition, or a biochemically induced microvascular abnormality from secretion of vasogenic mediators are possible mechanisms. indocyanine green angiography is helpful in making a definitive diagnosis. Clinicians should be aware that a retinal microangiopathy may occur in such eyes so that the proper diagnosis can be made and appropriate treatment administered.- - - - - - - - - - ranking = 3keywords = neovascularization (Clic here for more details about this article) |
4/15. Atypical parafoveal telangiectasis with subsequent anterior and posterior segment neovascularization.Bilateral parafoveal telangiectasis typically includes the presence of fluorescein staining of outer retinal capillaries, no macular ischemia, right-angled venules, and migration of pigment along these venules. In the bilateral form, atypical parafoveal telangiectasis with macular ischemia but without right-angled venules or migration of pigment along these venules has been reported in only five patients previously. An atypical case is presented of bilateral parafoveal telangiectasis complicated, not only by areas of macular nonperfusion, but also by peripheral ischemia with subsequent anterior and posterior segment neovascularization in the absence of any systemic abnormalities. As in previously reported cases, this patient had no evidence of right-angled venules or pigment migration. Pan-retinal photocoagulation resolved the rubeosis and caused regression of the retinal neovascularization.- - - - - - - - - - ranking = 6keywords = neovascularization (Clic here for more details about this article) |
5/15. Photodynamic therapy with verteporfin for subretinal neovascularization secondary to bilateral idiopathic acquired juxtafoveolar telangiectasis.The clinical course of a patient treated with multiple sessions of photodynamic therapy (PDT) with verteporfin for subretinal neovascularization secondary to bilateral idiopathic acquired juxtafoveolar telangiectasis is described. The patient presented with subfoveal subretinal neovascularization in one eye secondary to bilateral idiopathic acquired juxtafoveolar telangiectasis. The visual acuity improved from 5/40 to 20/60 and fluorescein angiography documented near-complete closure of the subretinal neovascularization within 2 weeks following the initial session of PDT. The visual acuity decreased to 20/200 and fluorescein angiography documented reperfusion of the neovascular membrane 6 weeks later. Four additional sessions of PDT were administered during the next 13 months with similar results. This case indicates that PDT for subretinal neovascularization due to bilateral idiopathic acquired juxtafoveolar telangiectasis may achieve partial short-term neovascular membrane closure and improvement in visual acuity.- - - - - - - - - - ranking = 8keywords = neovascularization (Clic here for more details about this article) |
6/15. Photodynamic therapy and intravitreal triamcinolone for a subretinal neovascularization in bilateral idiopathic juxtafoveal telangiectasis.PURPOSE: To report combined treatment of photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide injection for subfoveal neovascularization secondary to bilateral idiopathic juxtafoveal telangiectasis. DESIGN: Interventional case report. METHOD: A patient with a subfoveal neovascularization secondary to bilateral idiopathic juxtafoveal telangiectasis was treated with PDT plus an intravitreal injection of 4 mg of triamcinolone acetonide. RESULTS: Leakage in the late-phase of fluorescein angiography resolved with attenuation of telangiectatic vessels and improvement in visual acuity from 20/200 to 20/50. At 9 months post-treatment, recurrent leakage was treated with repeat PDT and intravitreal triamcinolone. One year after initial presentation, visual acuity was 20/60 with no leakage on fluorescein. CONCLUSION: Combined treatment with PDT and intravitreal triamcinolone acetonide resulted in regression of a subfoveal neovascular membrane and improvement in visual acuity during the course of follow-up.- - - - - - - - - - ranking = 6keywords = neovascularization (Clic here for more details about this article) |
7/15. Lack of apparent short-term benefit of photodynamic therapy in bilateral, acquired, parafoveal telangiectasis without subretinal neovascularization.PURPOSE: To analyze the results of photodynamic therapy (PDT) in bilateral acquired parafoveal telangiectasis. DESIGN: Interventional cases report. METHOD: Retrospective analysis of visual acuity measured with ETDRS charts and of fluorescein angiography findings for two women in whom the eye with lesser visual acuity was treated by PDT for bilateral acquired parafoveal telangiectasis without subretinal neovascularization. RESULTS: Initial visual acuity of the treated eye was 20/63 in both patients and did not change significantly for 3 to 6 months after one session of PDT. fluorescein angiography in both cases and optical coherence tomography in one case also appeared unchanged. No adverse effect has been observed. CONCLUSIONS: Photodynamic therapy was not beneficial for the outcome of these patients with bilateral acquired telangiectasis, because it improved neither their visual acuity nor their macular edema.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
8/15. Bilateral sequential photodynamic therapy for sub-retinal neovascularization with type 2A parafoveal telangiectasis.PURPOSE: To report the results of repeated bilateral sequential photodynamic therapy (PDT) with verteporfin for sub-retinal neovascularization associated with parafoveal telengiectasia. DESIGN: Interventional case series. methods: Three patients (minimum of 6-month follow-up) were analyzed after bilateral sequential PDT for parafoveal telengiectasia-associated sub-retinal neovascularization. RESULTS: Mean age was 53.3 /- 2.1 years. Mean and median follow-up duration were 12.3 and 10 months, respectively. Mean initial Early Treatment of diabetic retinopathy Study chart letter acuity was 30.6 in right eyes and 19 in left eyes, and at month 6, it was 30.6 in right eyes and 22.3 in left eyes. All patients received bilateral treatment three times; one eye received a fourth treatment. The greatest linear diameter was between 2310 and 5400 microm. CONCLUSION: PDT is a viable treatment for sub-retinal neovascularization associated with parafoveal telengiectasia. Bilateral sequential treatment is a convenient way to treat bilateral disease.- - - - - - - - - - ranking = 7keywords = neovascularization (Clic here for more details about this article) |
9/15. Use of intravitreal triamcinolone acetonide injection in unilateral idiopathic juxtafoveal telangiectasis.Idiopathic juxtafoveal telangiectasis (IJT) is one of the primary retinal telangiectasia that can result in visual impairment attributed to resultant cystoid macular oedema and rarely, choroidal neovascularization. The authors herein report successful treatment using intravitreal triamcinolone acetonide in a case of unilateral IJT that did not respond to prior laser photocoagulation. Serial optical coherence tomography was used to monitor the effectiveness of intravitreal triamcinolone acetonide in the treatment of IJT.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
10/15. Idiopathic juxtafoveal retinal telangiectasis: new findings by ultrahigh-resolution optical coherence tomography.OBJECTIVE: To investigate the capabilities of ultrahigh-resolution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, StratusOCT, for imaging of idiopathic juxtafoveal retinal telangiectasis (IJT); and to demonstrate that UHR OCT provides additional information on disease morphology, pathogenesis, and management. DESIGN: Retrospective, observational, interventional case series. PARTICIPANTS: Nineteen eyes of 10 patients diagnosed with IJT in at least one eye. METHOD: All patients were imaged with UHR OCT and StratusOCT at the same visit. A subset of patients was also imaged before and after treatment of IJT. MAIN OUTCOME MEASURES: Ultrahigh- and standard-resolution cross-sectional tomograms of IJT pathology. RESULTS: Using both standard- and ultrahigh-resolution OCT, we identified the following features of IJT: (1) a lack of correlation between retinal thickening on OCT and leakage on fluorescein angiography, (2) loss and disruption of the photoreceptor layer, (3) cystlike structures in the foveola and within internal retinal layers such as the inner nuclear or ganglion cell layers, (4) a unique internal limiting membrane draping across the foveola related to an underlying loss of tissue, (5) intraretinal neovascularization near the fovea, and (6) central intraretinal deposits and plaques. In 63% of cases, the presence of abnormal vessels and a discontinuity of the photoreceptor layer correlated with visual acuity. CONCLUSIONS: Ultrahigh-resolution OCT improves visualization of the retinal pathology associated with IJT and allows identification of new features associated with it. Some of these features, such as discontinuity of the photoreceptor layer, are revealed only by UHR OCT.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
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