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[Pacemaker erythema with telangiectasis ].

Pacemaker erythema is a rare, irreversible side effect of cardiac pacemakers, clinically characterized by epifocal teleangiectatic erythema. Histology reveals teleangiectatic vessels in the superficial dermis and a slight perivascular infiltrate. We report on three patients presenting with pacemaker erythema following either pacemaker or defibrillator implantation. The pathogenesis of this histopathologically uncharacteristic lesion is unknown. In contrast to peri- or postoperative pacemaker infections, physical irritation can be considered a possible triggering mechanism. Allergic reactions to the implanted material have been ruled out by negative patch test results.

Aged↗

Photodynamic therapy of subfoveal neovascular membrane in type 2A idiopathic juxtafoveolar retinal telangiectasis.

PURPOSE: To evaluate the effect of photodynamic therapy on subfoveal neovascular membrane related to type 2A idiopathic juxtafoveolar retinal telangiectasia. DESIGN: Interventional case series. METHODS: Retrospective review of four eyes of four patients who underwent photodynamic therapy for subfoveal neovascular membrane secondary to idiopathic juxtafoveolar retinal telangiectasia. Ocular photodynamic therapy with verteporfin was performed in all cases using standard protocols. Results are given in terms of final visual acuity and neovascular membrane activity based on clinical examination, fluorescein and indocyanin green angiography, and, in two cases, optical coherence tomography. RESULTS: Baseline visual acuity of 20/30 and 20/40 (x2) was maintained in three patients after one, two, and three sessions of photodynamic therapy respectively, and a follow-up of 23, 21, and 9 months. Leakage specific to the subfoveal neovascular membrane ceased on the fluorescein angiography. In the other patient, the final vision decreased from 20/50 to 20/200 after four sessions of photodynamic therapy and a follow-up of 14 months. Although there was still mild persistent leakage on the fluorescein angiography, neovascular membrane size was unchanged, and no subretinal fluid was demonstrated on optical coherence tomography. CONCLUSIONS: Data from this case series suggest that photodynamic therapy may be effective in managing subfoveal neovascular membrane associated with idiopathic juxtafoveolar retinal telangiectasia, which usually carries a poor visual prognosis. Prospective study is required to confirm the beneficial effect of this treatment.

Aged↗

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.

Female↗

Peripheral retinal telangiectasis in adults simulating a vascular tumor or melanoma.

In ten adult patients a localized peripheral retinal vascular lesion is described, which is characterized by retinal telangiectasia, formation of aneurysms, deposition of lipoidal material and exudative detachment. All patients were of middle or older age and men and women were affected equally. Small lesions had a definite association with the most peripheral vessels, whereas larger ones appeared more as a tumor-like mass causing exudative detachment with deposition of lipoidal material. Additional neovascularization was present in at least two of the ten patients. The lesion is of clinical importance because it is often the cause of loss of central vision and is often confused with a vascular tumor or a choroidal melanoma.

Adult↗