Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retinal Vascular Diseases
A 7-year-old male patient presented with visual loss related to marked submacular lipid exudation and fibrosis. He had superotemporal peripheral retinal telangiectasis.

  • Severe form of retinal telangiectasia
  • Typically presents in the first decade; average age 5
  • Clinical features:
    • Signs:
      • Telangiectatic vessels that appear as small, red "light bulbs" in the retinal periphery
      • Most often located in the inferior and temporal quadrants between the equator and ora serrata
      • Intraretinal and subretinal yellow exudation often affecting areas distant from the vascular abnormalities
      • Hard exudates commonly present in the posterior pole
      • Leukocoria in patients who present with extensive subretinal exudation
    • Ultrasonography is useful to exclude retinoblastoma
  • Differential diagnosis:
    • Retinal capillary angiomatosis or hemangioma
    • Late onset retinoblastoma
    • Toxocara endophthalmitis
    • Retinopathy of prematurity
    • Familial Exudative Retinopathy
    • Persistent primary hyperplastic vitreous
  • Management:
    • Cryotheraphy
    • Laser photocoagulation to the telangiectatic vessels
    • In advanced cases with total serous retinal detachment, external drainage of subretinal fluid and scleral buckling may be an option
    • Poor visual prognosis in cases of massive exudation

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