Integrated clinical evaluation of Type 2A idiopathic juxtafoveolar retinal telangiectasis

To describe spectral high-resolution optical coherence tomography (OCT) findings correlated with fundus autofluorescence (FAF), confocal blue reflectance (CBR), and fluorescein angiography (FA) patterns in patients affected by Type 2A idiopathic juxtafoveolar retinal telangiectasis.

We reviewed OCT, FA, CBR, and FAF images of both eyes from 11 patients affected by Type 2A idiopathic juxtafoveolar retinal telangiectasis. One eye had Stage 2 disease, 13 eyes had Stage 3 disease, 5 eyes had Stage 4 disease, and 3 eyes had Stage 5 disease. All the imaging modalities were obtained with a combined instrument for confocal scanning laser ophthalmoscopy and Spectral-domain OCT. Simultaneous acquisition of OCT images with FA, CBR, and FAF images was achieved with perfect point-to-point correspondence.

Increased parafoveal CBR was observed in all but 2 eyes that had Stage 5 disease. A correspondence of hyperautofluorescence on FAF and anatomical localization of the intraretinal cyst was observed in the 16 eyes where the cyst was visible by OCT. All eyes showed some alterations of the plexiform layers. A correspondence between increased CBR and late-phase FA hyperfluorescence occurred in the 4 eyes with focal and oval CBR pattern, whereas none of the 10 eyes with ring-pattern lesions had this correspondence. Patterns of increased CBR corresponded to areas of increased FAF in 94% of eligible eyes.

The simultaneous acquisition of Spectral-domain OCT and reference images (FA, FAF, and CBR) with point-to-point correlation may further add to the understanding of morphologic alterations in Type 2A idiopathic juxtafoveolar retinal telangiectasis.