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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
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Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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Hi I am a 46 years old male and I have been diagosed with Parafovial

Resolved Question:

Hi I am a 46 years old male and I have been diagosed with Parafovial telangiectasia (both eyes) and I have had one treatment with Lucentis with some positive results (The blood hemmoraging in my right eye and my vision improved from 20/30 to 20/50. I am due for a second injection, however, because my Retinal Specialist has little cinical experience treating patients with my condition was unable to provide me with a definitive treatment plan suggesting that the only thing he could reccomend is three treatments and then re-evaluate the situation. Two questions: Is it advisable to get a second opion before my next treatment with a doctor with more clinical experience? Given my condition is so rare where would I look to find a doctor who has had more experience treating my condition. Is there Directory of Retinal Specialists and there clinical experience/specialty I could access?. The botton line I simply want to make the optimal treatment decison weighing both risks of treatment and not taking definitive steps to deal with the situation. Your assistance with this is greatly appreciated! PH
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Stan replied 3 years ago.
Hello,

Welcome to Just Answer:

Parafoveal telangectasia are group of retinal abnormal blood vessel growths confined with the 1-199um of the center of the macular (fovea). There are several forms of this condition, making it difficult to apply the same or one standard approach of treatment to all forms of this condition. Type 1 affects one eye, and often associated with exduates in middle aged adults. Type 2 offten affects both eyes in middle aged adults, causing progressive blurring of central vision, but no exudates are involved. However, it can be associated with choroidal neovasular membrane with hemorrhage and macular detachment. It is for this reason that early intervention with Lucentis treatment to reduce the production of VEGF which promotes the new blood vessel growth and leakage. In general, it may be necessary to undergo 1-3 treatments of Lucentis before there is good stable occulsion of the abnormal blood vessel to prevent VEGF production. In general the visual recovery can improve to 20/25 after 1-3 treatments. Yet there is a type 3 parafeoval telangectasia which affects both eyes with associated capillary occulsion. This type general is more slowly progressive. In some cases, there is no treatment needed, with spontaneous improvement of vision. Overall, it is difficult to predict that natural course of parafoveal telangectasia as there are different forms. So, it would not be out of place to seek a second opinion after a second Lucentis treatment if you see no improvement of vision. In general, Lucentis would not worsen the condition. Another adjunct to Lucentis include focal retinal laser. So, I suggest that you ask your retinal eye doctor if there is a benefit to the use focal retinal laser early to permanently occlude the leaking blood vessels. To find a retinal eye surgeon in your area follow the below link:

http://www.asrs.org/patients/find_a_retina_specialist/index.php

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Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2701
Experience: Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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