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N. Acharya, M. Mughal, A. Lockwood, M.H. Ross; Parafoveal Telangiectasia – Prospective Follow–up and Treatment Outcomes . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4173.
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Purpose: To study the long term course of disease and treatment outcomes in cases of Parafoveal telangiectasia. Methods: 17 patients presenting with unilateral or bilateral parafoveal telangiectasia were studied over a long period of time ranging between 5 to over 10 years. Age of presentation, type of clinical presentation, classification under various clinical several sub–types, vision at time of presentation, visual deterioration if any over the period of time, progression of disease course, response to laser treatment, use of other modalities for diagnosis and treatment were studied. Association of any systemic or ocular conditions, were also looked for. All patients had recording of extensive history, symptoms at presentation, baseline vision assessment by snellen’s visual acuity, detailed ocular examination including fluorescein fundus angiography (FFA). Patients were seen at regular intervals of 4 to 6 months depending upon the presentation and progression of their disease process. FFA was repeated over the course of follow–up depending upon the clinical need and monitoring treatment outcomes. Argon laser treatment was done for lesions presenting with exudates, haemorrhages and macular oedema affecting central vision. Results: 12 males and 5 female patients were included. Mean time period of follow–up was 7 years ranging from 5 to over 10 years. Mean age of presentation was 63 years ranging from 41 to 87 years. All cases had presence of microaneurysms, exudates with or without macular oedema within central 3000 microns around fovea. Only 7 patients presented with visual disturbances, directly related to disease process, rest 10 were diagnosed on routine examination of ocular fundus for unrelated ocular conditions. 10 patients had bilateral involvement and 7 were unilateral. 2 cases out of 7 presenting with visual disturbance improved spontaneously. 3 did not progress maintaining vision of over 6/12, 4 progressed despite focal argon laser treatment with vision falling below 6/18. Only 2 out of 10 asymptmatic cases progressed. One stabilized after focal argon laser treatment with vision of 6/12 or better but one continued to progress despite multiple laser treatment with vision falling below 6/18. 1 case presented with CRVO of the other eye. 1 case presenting as unilateral disease developed peripheral lesions of coat’s disease. . Conclusions: Most of the patients are asymptomatic or have minimal involvement of vision, Laser treatment only helps in stabilizing the vision in such patients.
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