Abstract
Purpose: To describe a case of Type 2 macular telangiectasia (MacTel) presenting with decreased vision due to intraretinal/sub-internal limiting membrane (ILM) haemorrhage in the absence of choroidal neovascularization (CNV), with spontaneous resolution and improvement in visual acuity.
Method: Clinical examination was performed, as was multimodal imaging including Spectralis OCT, multicolour, autofluorescence (AF) and fluorescein angiography (FA).
Results: A 65-year-old lady presented with 6-day history of left blurred vision. She was taking non-steroidal anti-inflammatories (NSAIDs), and denied Valsalva manoeuvres.
At presentation, BCVA was 6/18 right and 6/48 left. There was intraretinal haemorrhage at the left macula centrally, with sub-ILM haemorrhage above and below. OCT showed no evidence of CNV. OCT and AF of the right macula was consistent with MacTel. She was commenced on anti-hypertensives for BP of 170/84 mmHg, and NSAIDs were ceased.
The blood spontaneously cleared and the left VA gradually improved to 6/7.5 by 4 months. Fluorescein angiography confirmed MacTel, and once the haemorrhage resolved, both inner and outer retinal cavitation was identified on OCT. The left BCVA remained at 6/7.5 at 13 months follow-up.
Conclusion: This is a case of MacTel presenting with intraretinal/sub-ILM hemorrhage in the absence of CNV. We postulate that the combination of hypertension and NSAIDs contributed to the presentation, likely resulting from rupture of an inner retinal vessel. Intravitreal therapy or surgical intervention was not required and resorption of haemorrhage was accompanied by visual improvement.
Method: Clinical examination was performed, as was multimodal imaging including Spectralis OCT, multicolour, autofluorescence (AF) and fluorescein angiography (FA).
Results: A 65-year-old lady presented with 6-day history of left blurred vision. She was taking non-steroidal anti-inflammatories (NSAIDs), and denied Valsalva manoeuvres.
At presentation, BCVA was 6/18 right and 6/48 left. There was intraretinal haemorrhage at the left macula centrally, with sub-ILM haemorrhage above and below. OCT showed no evidence of CNV. OCT and AF of the right macula was consistent with MacTel. She was commenced on anti-hypertensives for BP of 170/84 mmHg, and NSAIDs were ceased.
The blood spontaneously cleared and the left VA gradually improved to 6/7.5 by 4 months. Fluorescein angiography confirmed MacTel, and once the haemorrhage resolved, both inner and outer retinal cavitation was identified on OCT. The left BCVA remained at 6/7.5 at 13 months follow-up.
Conclusion: This is a case of MacTel presenting with intraretinal/sub-ILM hemorrhage in the absence of CNV. We postulate that the combination of hypertension and NSAIDs contributed to the presentation, likely resulting from rupture of an inner retinal vessel. Intravitreal therapy or surgical intervention was not required and resorption of haemorrhage was accompanied by visual improvement.
| Original language | English |
|---|---|
| Pages (from-to) | 121 |
| Number of pages | 1 |
| Journal | Clinical and Experimental Ophthalmology |
| Volume | 44 |
| Issue number | S1 |
| Publication status | Published - Nov 2016 |
| Event | Annual Scientific Congress of the Royal Australian and New Zealand College of Ophthalmologists (48th : 2016) - Melbourne, Australia Duration: 19 Nov 2016 → 23 Nov 2016 |