Juxtafoveal Telangiectasis - Also Juxtapapillary CNVM from AMD
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82-year-old woman was seen in the office on 12-21-07. She has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. You saw a problem with the retina and suggested she come back in here for evaluation.
VISUAL ACUITY: Her vision OD 20/100, OS 20/40. IOP: OD 13, OS 14.
The right eye has a posterior chamber intraocular lens in perfect potion, left eye has 3+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is a hyperpigmentation in the macula with retinal atrophy. There is a juxtapapillary choroidal neovascular membrane just on the inferotemporal part of the optic nerve with exudate and thickening of the pigment epithelium and fluid.
OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation or retinal crystals. Floaters confirm clinical finding.
A fluorescein angiogram shows leakage from a juxtapapillary choroidal neovascular membrane in the right eye, which appears to spare the fovea. There is also staining of the macular irregularities. The left eye has difficult temporal staining.
An OCT scan of the right eye shows central retinal atrophy as does the left eye. There is some juxtapapillary subretinal fluid corresponding to neovascular membrane, but it does not get into the fovea. The left eye has a few retinal cysts.
IMPRESSION:
1. GROUP II-A JUXTAFOVEAL AND TELANGIECTASIA IN BOTH EYES.
2. JUXTAPAPILLARY EXTRAFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE RIGHT EYE, WHICH MAY OR MAY NOT BE EFFECTING HER CENTRAL VISION.
DISCUSSION: I explained to the patient that she does have retinal telangiectasis, which is adversely effecting her central vision. In addition to that there may be some contribution to the central vision loss from the juxtapapillary choroidal neovascular membrane. I suggested we can try Avastin, which in her case might dry up the macula and might improve the vision, however, given the duration of the poor vision in the right eye and the extent of the retinal atrophy on OCT scanning I suspect there is less than a 50% chance of it helping her, maybe around 25% chance. I do not think there is any rush in her and she would rather think about this for a while.
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye466 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(0 votes)
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye622 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(1 votes)
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye512 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(0 votes)
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye519 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(0 votes)
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye471 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(0 votes)
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye531 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(0 votes)
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye428 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(0 votes)
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Juxtfoveal Telangiectasis Group 2a - Type II - MacTel - also Juxtapapillary Asymptomatic CNVM Right Eye515 views82-year-old woman who has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. OD 20/100, OS 20/40.
(0 votes)
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82-year-old woman was seen in the office on 12-21-07. She has juxtafoveal retinal telangiectasis in both eyes. She recently had cataract surgery in the right eye and the vision in the right eye is still limited. You saw a problem with the retina and suggested she come back in here for evaluation.
VISUAL ACUITY: Her vision OD 20/100, OS 20/40. IOP: OD 13, OS 14.
The right eye has a posterior chamber intraocular lens in perfect potion, left eye has 3+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is a hyperpigmentation in the macula with retinal atrophy. There is a juxtapapillary choroidal neovascular membrane just on the inferotemporal part of the optic nerve with exudate and thickening of the pigment epithelium and fluid.
OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation or retinal crystals. Floaters confirm clinical finding.
A fluorescein angiogram shows leakage from a juxtapapillary choroidal neovascular membrane in the right eye, which appears to spare the fovea. There is also staining of the macular irregularities. The left eye has difficult temporal staining.
An OCT scan of the right eye shows central retinal atrophy as does the left eye. There is some juxtapapillary subretinal fluid corresponding to neovascular membrane, but it does not get into the fovea. The left eye has a few retinal cysts.
IMPRESSION:
1. GROUP II-A JUXTAFOVEAL AND TELANGIECTASIA IN BOTH EYES.
2. JUXTAPAPILLARY EXTRAFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE RIGHT EYE, WHICH MAY OR MAY NOT BE EFFECTING HER CENTRAL VISION.
DISCUSSION: I explained to the patient that she does have retinal telangiectasis, which is adversely effecting her central vision. In addition to that there may be some contribution to the central vision loss from the juxtapapillary choroidal neovascular membrane. I suggested we can try Avastin, which in her case might dry up the macula and might improve the vision, however, given the duration of the poor vision in the right eye and the extent of the retinal atrophy on OCT scanning I suspect there is less than a 50% chance of it helping her, maybe around 25% chance. I do not think there is any rush in her and she would rather think about this for a while.
