J. A. Reichelt

The diagnosis of parafoveal telangiectasis in fluorescein angiography does not cause difficulties. The pathogenesis, however, is unknown. Associations with other diseases, e.g. diabetes mellitus, is postulated. In our outpatient-clinic we saw a case of bilateral parafoveal telangiectasis in combination with idiopathic choroidal folds. This combination has not been described so far.

Case: A 39-year-old female patient complained of bilateral blurred vision for five years which had been treated with vitamin preparations. The course was slowly progressive. In her history no ocular disorders beyond low-grade hypermetropy with astigmatism are known.

At first presentation in our outpatient-clinic best corrected visual acuity was 20/80 in both eyes. Ophthalmoscopy revealed white changes in the nerve fibre layer. At an angle of 5° to 7° from fixation axis relative scotoma could be found. Choroidal folds were obvious in both eyes. In fluorescein-angiography paravoveal telangiectasis appeared early with decent late leakage. Further examination including ERG and EOG revealed normal findings. A general internal disorder could be ruled out. Orbital causes of choroidal folds were not found by ultrasound or magnetic resonance tomography. Ocular hypotony as a cause of choroidal folds could not be found. Ophthalmoscopy did not reveal angiomatous lesions in the periphery.

Result: The case is characterized by parafoveal telangiectasis group II according to Gass with choroidal folds which have not been described before. Within 17 months visual acuity varied and was 20/200 in the right eye and 20/32 in the left eye finally. In 10° computer-perimetry relative scotoma persisted.

Conclusion: On the base of this case presentation it cannot be stated if choroidal folds are a pathogenic factor in the development of parafoveal telangiectasis or if they are an epi-phenomenon. A common pathogenesis of choroidal folds as well as lelangiectasis, e.g. by an underlying connective tissue disease, may be discussed. Collecting further cases of bilateral parafoveal telangiectasis in combination with idiopathic choroidal folds is necessary in order to gain a more detailed picture of this disease.

Department of Ophthalmology, Christian-Albrechts-University Kiel, Hegewischstrasse 2, D-24105 Kiel, Germany

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