Type II idiopathic macular telangiectasia and soft confluent drusen

To describe the simultaneous presentation of soft confluent drusen and type 2 idiopathic macular telangiectasia (IMT) in both eyes of one patient.

A 79-year-old man with bilateral metamorphopsia and gradual reduction of central vision underwent a complete ophthalmologic examination.

In this patient, fundus biomicroscopy revealed soft confluent drusen and a cystic appearance within the fovea, and fluorescein angiography (FA) showed late dye leakage. Interestingly, indocyanine green angiography (ICGA) showed absence of late hypercyanescence, and spectral domain optical coherence tomography (Spectralis SD-OCT) clearly revealed the presence of bilateral foveal cysts with thinning and loss of the normal architecture of the outer retina, as well as absence of retinal thickening within the parafoveolar area showing discrete late dye leakage on FA. Based on these findings, the patient was diagnosed with nonexudative age-related macular degeneration with foveal soft confluent drusen, and coincident nonproliferative type 2 IMT.

To our knowledge, there is no previously reported case of simultaneous presentation of soft confluent drusen and type 2 IMT. This report highlights the importance of ICGA and OCT in the correct diagnosis of such cases.