Case Report: Photodynamic Therapy for Macular Edema in Unilateral Juxtafoveal Telangiectasis Clinical, Angiographic and Optical Coherence Tomography Features

Abstract

Abstract: : Purpose: To report the efficacy of photodynamic therapy (PDT) in unilateral idiopathic juxtafoveal telangiectasis (type I) causing macular exudation. Methods: Retrospective analysis of EDTRS Visual Acuity (VA), biomicroscopy, fluorescein angiography (FA) and optical coherence tomography (OCT) was performed before and after PDT treatment for exudative parafoveal telangiectasis without choroidal neovascularisation. Results: The patient was a 67 years old non diabetic man, and presented a progressive decrease of VA (20/40 to 20/100) despite telangiectasis focal laser photocoagulation treatment 5 years previously. Biomicroscopic findings included: punctuate hemorrhages, telangiectasiae, lipid deposits and cystic macular edema affecting the inferior temporal macula quadrant. FA confirmed unilateral telangiectasis. OCT showed cystic edema and increase of foveal thickness (447 µ). After first PDT application, vision increased to 20/80 associated with stabilisation of foveal thickness (430 µ). 6 months later, a second PDT session was performed because of persistant exudation. 13 months after first PDT and 7 months after the second treatment, lipid exudates and macular edema decreased (226 µ) and vision improved to 20/64. Conclusions: Idiopathic juxtafoveal retinal telangiectasis with exudation causes visual disturbance. In this case of unilateral telangiectasis, PDT appeared to improve short–term VA and was associated with decrease of macular edema on OCT.

Keywords: age-related macular degeneration • photodynamic therapy