Idiopathic juxtafoveal retinal telangiectasia

Idiopathic juxtafoveal retinal telangiectasia (IJRT) is a rare retinal condition that can be detected even in asymptomatic patients. The most common appearance, type 2A, typically presents as juxtafoveolar telangiectasias with minimal exudation, superficial retinal crystalline deposits, and right-angle venules. Though initially asymptomatic, late complications such as foveolar atrophy and subretinal neovascularization can develop and should be recognized and treated accordingly.

Two patients with IJRT are presented. The first patient, a 60-year-old Hispanic man, had asymptomatic type 2A IJRT with subretinal neovascularization diagnosed for which he underwent photodynamic therapy on 2 separate occasions. Currently, his visual acuity remains stable at 20/30 in the treated eye. The second patient, a 78-year-old man, had bilateral type 2A IJRT with decreased vision. Fluorescein angiography found no active leakage, and optical coherence tomography found significant foveal atrophy. Therefore, no treatment was advised, and the patient remains with acuities of 20/100- in the right eye and 20/80- in the left.

Initially, retinal signs can be subtle in type 2A IJRT, with no treatment being indicated. In the late stages of the disease, laser photocoagulation may be necessary to treat subretinal neovascular membranes, which can result as a complication, leading to dramatic vision loss if the fovea is affected. Careful inspection, including the use of fluorescein angiography and ocular coherence tomography, is often helpful in monitoring these patients.