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Idiopathic parafoveal telangiectasis (IPT) and basal laminar drusen with pseudovitelliform lesions are both uncommon ocular findings.1,2 Gass classified parafoveal telangiectasis into several groups. Group 2 is characterised by bilateral acquired parafoveal telangiectasis that usually becomes clinically apparent later in life, in the fifth and sixth decade. The zones of telangiectasis tend to be symmetric and measure up to one disc diameter, with preferential involvement of the temporal parafoveal region. Typical findings are minimal retinal oedema, “right angle” veins, which drain the telangiectatic areas, underlying retinal pigment epithelial (RPE) alterations and superficial retinal refractile deposits. Gass has also described the development of a small, foveal yellow pseudovitelliform lesion in some patients, but no associated basal laminar drusen were noted.1 Abnormal blood glucose metabolism may play a part in the development of IPT.3
Basal laminar or cuticular drusen are focal thickenings of the basement membrane of the RPE. Although they are sometimes difficult to detect on clinical examination, these basal laminar drusen present a striking fluorescein angiographic picture of innumerable uniform, small, slightly raised, hyperfluorescent nodules.2 Patients with basal laminar drusen may develop a yellowish exudative macular detachment (“pseudovitelliform lesion”) that may resemble the foveal lesion characteristic of Best’s vitelliform dystrophy. In some cases, the yellow material may gravitate to the inferior part of the detachment, producing a “pseudohypopyon” appearance. Typically, the pseudovitelliform material shows progressive staining with fluorescein dye during the course of the angiogram.2
This case report …
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Financial interest: none.