Telangiectasic changes in Retina due to telangiectasia.
It can be maily due to systemic causes.
References :- Clinical ophthalmology & comprehensive ophthalmology
2. TELANGIECTASIA
It is a condition in which tiny blood vessels cause
thread like red lines or patterns on the skin.
They are sometimes known as spider veins.
Diameter 0.52mm to 1.00mm
3. Cause :
The exact cause is unknown .
It may be genetic , environmental or combination
of both. It is believed that most causes of
telangiectasia are caused by chronic exposure to
sunlight.
4. Other possible causes :
Alcoholism: can affect flow of blood in vessels.
Pregnancy: due to large pressure on venules.
Aging : aging blood vessels can begin to weak.
Rosacea: enlarges venules in face, creating flushed
appearance
in nose and cheeks
corticosteroid use: thins and weakens the skin
Scleroderma: hardens and contracts the skin
7. TREATMENT
Laser therapy: Laser target the widened vessels and
seals it.
Surgery: widen vessels can be removed.
Sclerotherapy.
8. It refers to the rare idiopathic congenital or acquired
retinal vascular malformation.
It is characterized by the irregular dilation of capillary
bed ,deposition of hard exudates and dilation of
venules and arterioles.
9. It includes :-
Idiopathic juxtafoveolar retinal telangiectasia.
Coat’s disease.
Leber’s military aneurysm.
10. Idiopathic juxtafoveolar retinal telangiectasia.
It is also known as idiopathic macular telangiectasia.
It rare , congenital or acquired .
It is a rare condition presenting with mild decrease in
visual acuity due to exudation from the juxtafoveolar
telangitatic retinal capillaries.
This condition has been divided into three groups 1, 2
and 3 and it is subdivided into A and B depending on
the characteristics of the lesion.
11. GROUP ONE : 1 A
Congenital , unilateral, easily visible and macular oedema.
Mild moderate blurring of vision .
About 1.5 disc diameters in area temporal to fovea and
hard exudates . ( 14.112a, b)
FFA shows capillary dilation ( 14.112c ) and late leakage
(14.112 d )
Treatment : laser photocoagulation.
12.
13. GROUP ONE : 1 B
Affects middle aged men .
FFA shows absence of leakage .( 14.113 c )
TREATMENT : Not appropriate and prognosis is
good.
14.
15. GROUP TWO : Bilateral parafoveolar
telangiectasia
Present in the fifth to sixth decades with mild .
Slowly progressive disturbance of central vision.
SIGNS:
Telangiectasia ,stellate plaques of RPE hyperplasia.
Multipal glistening dots are present.
FFA : shows capillary dilation outside FAZ. ( 14.114A ).
Late leakage ( 14.114b ).
16.
17. Most severe form typically present In sixth decade .
Very rare , acquired .
Slowly progressive loss of central vision
SIGNS : Aneurysmal dilatation of terminal capillaries and
parafoveal capillaries.
Optic atrophy may be present.
FFA shows widening of FAZ but absence of leakage .
Prognosis usually poor.
GROUP THREE : BILATRAL PERIFOVEAL
TELANGIECTASI AND CAPILLARY OCCLUSION :
18. Coat’s disease
It is also known as exudative retinopathy of coat’s.
It is severe from retinal telangiectasia.
19. Characteristics of coat’s disease:-
Typically affects one eye of boys in their first decade of
life.( 5 yrs )
In early stages it is characterized by large areas of intra (
14.120 ) and sub(14.121 a) retinal yellowish exudates and
hemorrhages associated with overlying dilated and retinal
blood vessels and number of small aneurysm near the
posterior pole around the disc.
It may present with visual loss , strabismus , leukocoria . (
14.118)
Conditions usually progresses to produce exudative retinal
detachment and retro lantal mass .
20.
21.
22.
23. • In late stages of complicated cataract ,uveitis and secondary
glaucoma occur which eventually end in pthisis bulbi.
FFA highlights abnormal vessels , leakage and areas of
capillary dropout.
• Aneurysm formation and hard exudates . ( 14. 121 b )
24.
25. TREATMENT
Photocoagualation :
Cryotherapy : with double freeze thaw method .
It may check progression of the disease if applied in
early stage.
However, when the retinal detach the treatment
became increasingly difficult and success rate
declines to 33%.
Vitreoretinal surgery : in eyes with deep retinal
detachment .
26. Leber’s miliiary aneurysm.
It is essentially localize less severe form of the coat’s
disease presenting in adults with decrease vision.
It is characterised by local area of fusiform and
saccular aneurysmic (small pouches )dilation of
venules , most common involving the temporal retinal
periphery( 14.115)
Chronic leakage results in intraretinal hard exuadate
formation which may involve the macula .
27.
28. FFA during the early phase highlights the vascular
anomalies and show areas of retinal non perfusion.
• The late phase of FFA shows leakage ( 14.116 c )
Prognosis is depends upon extent of foveal
involvement ( 14.117 a )
Treatment : photocoagulation ( 14.117 b )