Department of Retina and Vitreous Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, India.
Retin Cases Brief Rep. 2024 Mar 1;18(2):230-235. doi: 10.1097/ICB.0000000000001348.
To report a rare presentation of unilateral macular telangiectasia Type 2 followed up over 5 years.
Case report.
A 58-year-old man presented to us with complaints of painless progressive reduction of vision in the right eye for the past 2 years. He had no systemic illnesses. On examination, his best corrected visual acuity was 20/40 in the right eye and 20/20 in the left eye. Fundus examination in the right eye revealed loss of foveal reflex along with mild temporal graying of the fovea, and the left eye revealed results within the normal limits. Both eyes showed the presence of peripapillary myelinated nerve fibers. Multimodal imaging findings included spectral-domain optical coherence tomography, optical coherence tomography angiography, fundus autofluorescence, and fundus fluorescein angiogram, which revealed findings suggestive of exudative preproliferative variant of Mac-Tel 2 in the right eye, whereas the left eye was showed results within normal limits. After a follow-up of 5 years, spectral-domain optical coherence tomography and optical coherence tomography angiography revealed no striking differences in both eyes, with no evidence of the disease in his left eye.
This report highlights a rare advanced unilateral presentation of Mac-Tel 2 with no evidence of even early signs of the disease in the fellow eye, over a long-term follow-up.
报告一例罕见的单侧 2 型黄斑毛细血管扩张症的表现,并对其进行了 5 年的随访。
病例报告。
一名 58 岁男性因右眼无痛性渐进性视力下降 2 年来我院就诊。他没有系统性疾病。检查发现,他的右眼最佳矫正视力为 20/40,左眼为 20/20。右眼眼底检查发现黄斑区光反射丧失,同时伴有轻微的颞侧黄斑灰色变,左眼眼底检查结果正常。双眼均可见视盘周围髓鞘神经纤维。多模态成像检查包括频域光相干断层扫描、光相干断层扫描血管造影、眼底自发荧光和眼底荧光血管造影,结果提示右眼为渗出性前增生型 2 型黄斑毛细血管扩张症,而左眼检查结果正常。经过 5 年的随访,频域光相干断层扫描和光相干断层扫描血管造影显示双眼无明显差异,左眼无疾病迹象。
本报告强调了一例罕见的单侧晚期 2 型黄斑毛细血管扩张症,在长期随访中,对侧眼甚至没有早期疾病的迹象。