I have just been diagnosed with bilateral juxtafoveal telangiectasia--via fluoriscein angiography and exam. I do not have diabetes, however, I am hypertensive--I am 56 years of age, female. My opthamologist told me there was no treatment of cure for this condition. Is this true? How did this happen? Can you explain what it is in plain language (something my doctor didn't do). Should I go for a 2nd opinion? Thank you for your time and information.
Idiopathic juxtafoveal telangiectasia is the medical name for a condition in which the capillaries around the central retina in one or both eyes are abnormally kinked, dilated, and leaky. Some patients have this condition from birth. In this group, no one knows why the abnormality in development of the vessels occurs. Another group of patients acquire the abnormality in middle or later life. From one third to one half of the latter group have been found to have abnormal glucose metabolism even though fasting blood glucose levels are normal. Thus, even though you say in your e-mail that you do not have diabetes, it may be worthwhile to check a glucose tolerance test. The article in American Journal of Ophthalmology 102:363, 1986 by Millay and colleagues addresses this. It is true that little exists in the way of treatment for this condition at present. Laser treatment usually does not help. Recently there has been some optimism regarding injections of triamcinolone in eyes with leakage from this condition, but not enough experience has been obtained to be sure this is valid. Newer forms of laser treatment such as photodynamic therapy, in which a photoactive dye is first injected intravenously, and then excited by a laser light without causing a burn to the retina, have not shown particular promise in the few cases in which they were used. A second opinion is always a good idea for an unusual diagnosis for which no good treatment is known. I would encourage you to seek a retina specialist for this visit.