Spectral-domain optical coherence tomography findings in idiopathic juxtafoveal retinal telangiectasis type 2a

Abstract

PURPOSE: To describe the spectral-domain optical coherence tomography (OCT) findings in a patient with idiopathic juxtafoveal retinal telangiectasis (IJRT) type 2A and correlate them with the fluorescein angiography (FA) signs. METHODS: Case report. PATIENT: A 59 years old male patient presented with slow decrease in vision and metamorphopsia, most prominent in his left eye. The ophthalmoscopic and FA examination set the diagnosis of IJRT type 2A nonproliferative stage 3 in the right eye and proliferative stage 5 in the left eye [2]. RESULTS: The spectral-domain OCT revealed thickness decrease and reflectivity attenuation of the outer layers, deep intraretinal vessels located in the outer nuclear layer in the right eye and presence of a subretinal neovascularisation (SRN), undisrupted retinal pigment epithelium (RPE) and disintegration of the outer layers in the left eye. There was not presence of cystoid spaces, internal limiting membrane draping or pigment hyperplasia lesions in both eyes. The extensive leakage on FA seemed not to correspond to the relatively normal in thickness retina in both eyes. Spectral-domain OCT showed the intraretinal location of the SRN and the integrity of the RPE over the entire macula that could facilitate the differentiation between neovascular IJRT and choroidal neovascularisation from various ethiology or retinal angiomatous proliferation. CONCLUSION: IJRT type 2A presents with variable OCT characteristics. Ophthalmoscopy and FA are the routine methods for disease diagnosis. Spectral-domain OCT could further distinguish changes in retinal microstructure. It could be a helpful tool in differentiating IJRT from other entities. The importance of OCT for early diagnosis, evaluation of prognostic factors and monitoring the follow-up could be elucidated in longitudinal prospective studies.