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Fibrovascular tissue in bilateral juxtafoveal telangiectasis.

OBJECTIVE: To study the natural history and retinal findings associated with the intraretinal and subretinal fibrovascular tissues that develop in the late phases of bilateral juxtafoveal telangiectasis. METHODS: The records of 10 patients (11 eyes) with bilateral juxtafoveal telangiectasis who developed these fibrovascular tissues were examined. RESULTS: Throughout the follow-up period (average 44 months), only 2 eyes (18%) lost 2 or more lines of vision; the final visual acuities were similar for the eyes both with and without fibrovascular tissues. Sixty-four percent of fibrovascular tissues showed little to no growth. Eyes with fibrovascular tissue commonly had retinal pigment epithelial hyperplasia (72%), draining retinal venules (82%), and retinal vascular distortion (64%). CONCLUSIONS: Fibrovascular tissues of bilateral juxtafoveal telangiectasis have little proliferative potential and minimal effects on visual acuity. Nevertheless, these fibrovascular tissues do remodel over time, leading to retinal vascular distortion. Given these benign findings, the role of laser photocoagulation treatment of these tissues is questionable.

Aged↗

Familial parafoveal telangiectasis.

We report two cases of parafoveal telangiectasis encountered in the same family. The patients are father and son. Both patients are healthy. Both presented with small parafoveal telangiectatic vessels, with minimal associated subretinal fluid. There were no other associated conditions. To the best of our knowledge these cases represent the first reported cases of father-to-son transmission of parafoveal telangiectasis.

Adult↗

Adult Coats' disease in branch retinal vein occlusion.

We report a case of adult Coats disease secondary to a branch retinal vein occlusion. Angiograms show the relationship of the peripheral telangiectasis, aneurysm formation and vascular incompetence to the peripheral retinal ischaemia. The possible role of vascular remodelling in the pathogenesis of this uncommon complication of a common condition is discussed.

Exudates and Transudates↗

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.

Female↗

New findings in the Parry-Romberg syndrome: a case report.

PURPOSE: To describe further findings in the Parry-Romberg syndrome that might contribute towards a better understanding of the disease. DESIGN: Case report. METHODS: The clinical history of a patient with the Parry-Romberg syndrome was studied, and fluorangiography and echography were carried out. RESULTS: Clinical observation revealed classic hemifacial atrophy; fluorescein angiography showed telangiectasis, light staining of the retina, and leakage from the largest telangiectasis and the optic disc vessels; echography showed shrinkage of the eyeball and thinning of the extraocular muscles. CONCLUSIONS: Enophthalmos in this disease is caused not only by progressive fat atrophy but also by shrinkage of the eyeball and thinning of the extraocular muscles; the shrinkage of the eyeball helps explain the presence of choroidal and retinal folding and hyperopia, confirming the primary involvement of connective tissue in this disease.

Child↗

Parafoveal telangiectasis and diabetic retinopathy.

Five patients with mild nonproliferative diabetic retinopathy had visual loss associated with parafoveal telangiectasis. Minimal macular edema with characteristic parafoveal plaques of subretinal pigment epithelial hyperplasia was seen in all patients. Fluorescein angiography revealed the presence of ectatic, dilated, leaking perifoveal capillaries. The occurrence of parafoveal telangiectasis in patients with diabetic retinopathy has, to our knowledge, not been previously described. One previous clinicopathologic report described the histologic appearance of parafoveal telangiectasis in a nondiabetic patient to be similar to that seen in diabetic patients. The association of parafoveal telangiectasis and diabetic retinopathy raises interesting speculations into the pathogenesis of the entity of parafoveal telangiectasis. In addition, the importance of obtaining fluorescein angiography prior to therapy of diabetic macular edema is emphasized.

Aged↗

Leber's miliary aneurysms associated with telangiectasia of the nasal mucosa.

A 20-year-old woman, treated with cryopexy and xenon- and argon-laser photocoagulation for Leber's miliary aneurysms in her right eye, suffered from repeated epistaxis. She underwent an endoscopy that showed an unusual number of telangiectatic veins. Laboratory results and routine physical and neurologic examinations showed normal values. Dematologic examination revealed no signs of hereditary hemorrhagic telangiectasis (Osler's disease). Nevertheless, it seems reasonable to assume that the combination of microvascular disturbances in one eye and in the nasal mucous membrane is not a coincidental finding.

Adult↗

Subretinal neovascular membrane associated with type 2a idiopathic juxtafoveolar telangiectasis in pseudoxanthoma elasticum.

BACKGROUND: The objective was to report a case of pseudoxanthoma elasticum associated with type 2A idiopathic juxtafoveolar telangiectasis (T2AIJT) complicated by bilateral subretinal neovascular membranes (SRNVM). METHODS: The right eye with juxtafoveal SRNVM and the left eye with subfoveal SRNVM underwent laser photocoagulation and photodynamic therapy respectively. The follow-up duration was 48 months. RESULTS: Best corrected visual acuity was 20/32 in both eyes at baseline, and 20/32 in the right eye and 20/200 in the left eye at the end of the follow-up. Atrophic changes in the retinal pigment epithelium developed around the SRNVM treated with photodynamic therapy (PDT). CONCLUSIONS: Pseudoxanthoma elasticum may be associated with T2AIJT complicated by bilateral SRNVM. Further studies are needed to assess both efficacy and appropriate PDT regime in T2AIJT-related SRNVM, especially if associated with other conditions.

Coloring Agents↗

[Idiopathic parafoveal telangiectasias].

The authors describe the clinical and angiographic picture of idiopathic parafoveal telangiectasis in 6 patients (10 eyes). Three forms of the condition were distinguished: edematous, occlusive, and with subretinal shifts. A natural course of the process is traced, the criteria and terms of laser coagulation are defined.

Adult↗

[Group 2A idiopathic parafoveal telangiectasis].

CASE REPORT: Two cases of group 2A idiopathic parafoveal telangiectasis associated with abnormal glucose metabolism are reported with the typical sings of this disease as well as a foveal vitelliform lesion in one patient, an infrequent association. DISCUSSION: Group 2A idiopathic parafoveal telangiectasis are a disease with well characterized clinical signs, being some very infrequent such as a vitelliform maculopathy. Its pathogenesis seems to be linked to some alterations in the parafoveal capillary network endothelial cells. These alterations are similar to those that appear in the beginning of the diabetic retinopathy.

Aged↗

Cystoid macular edema secondary to juxtafoveolar telangiectasis in Coats' disease.

A 28-year-old man with unilateral Coats' disease and cystoid macular edema secondary to juxtafoveolar telangiectasis underwent successful juxtafoveolar argon green laser photocoagulation therapy with resolution of the edema and improvement in metamorphopsia and visual acuity. Despite this success, the effect of laser therapy in these patients remains uncertain. It should be considered only after detailed discussion with the patient about the possibility of posttreatment paracentral scotomata and the alternative of a reasonable period of observation for possible spontaneous resolution of the edema.

Adult↗

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.

Drug Therapy, Combination↗