Telangiectasic changes in Retina due to telangiectasia. It can be maily due to systemic causes. References :- Clinical ophthalmology & comprehensive ophthalmology

1. By:-
Harsh Jain
(II year-B.OPTOM.)

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

5. Symptoms :
1. Pain(related to pressure on venules .)
2. Itching
3. Thread like red marks on 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.

13. GROUP ONE : 1 B
Affects middle aged men .
FFA shows absence of leakage .( 14.113 c )
TREATMENT : Not appropriate and prognosis is
good.

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 ).

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 .

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 )

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 .

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 )