Objective: To investigate the capabilities of ultrahighreso-lution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, StratusOCT, for imaging of idiopathic juxtafoveal retinal telangiectasis (IJT); and to demonstrate that UHROCT provides additional information on disease morphology, pathogenesis, and management. Design: Retrospective, observational, interventional case series. Participants: Nineteen eyes of 10 patients diagnosed with IJT in at least one eye. Method: All patients were imaged with UHR OCT and StratusOCT at the same visit. A subset of patients was also imaged before and after treatment of IJT. Main Outcome Measures: Ultrahigh-and standard-resolution cross-sectional tomograms of IJT pathology. Results: Using both standard-and ultrahigh-resolution OCT, we identified the following features of IJT: (1) a lack of correlation between retinal thickening on OCT and leakage on fluorescein angiography, (2) loss and disruption of the photoreceptor layer, (3) cystlike structures in the foveola and within internal retinal layers such as the inner nuclear or ganglion cell layers, (4) a unique internal limiting membrane draping across the foveola related to an underlying loss of tissue, (5) intraretinal neovascularization near the fovea, and (6) central intraretinal deposits and plaques. In 63%of cases, the presence of abnormal vessels and a discontinuity of the photoreceptor layer correlatedwith visual acuity. Conclusions: Ultrahigh-resolution OCT improves visualization of the retinal pathology associated with IJT and allows identification of new features associated with it. Some of these features, such as discontinuity of the photoreceptor layer, are revealed only by UHR OCT. Objective: To investigate the capabilities of ultrahighreso-lution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, Stratus OCT, for imaging of idiopathic juxtafoveal retinal telangiectasis (IJT); and to demonstrate that UHROCT provides additional Information on disease morphology, pathogenesis, and management. Design: Retrospective, observational, interventional case series. Participants: Nineteen eyes of 10 patients diagnosed with IJT in at least one eye. Method: All patients were imaged with UHR OCT and Stratus OCT at the same A subset of patients was also imaged before and after treatment of IJT. Main Outcome Measures: Ultrahigh-and standard-resolution cross-sectional tomograms of IJT pathology. Results: Using both standard-and ultrahigh-resolution OCT, we identified the following features of IJT: (1) a lack of correlation between retinal thickening on OCT and leakage on fluorescein angiography, (2) loss and dis ruption of the photoreceptor layer, (3) cystlike structures in the foveola and within internal retinal layers such as the inner nuclear or ganglion cell layers, (4) a unique internal limiting membrane draping across the foveola related to an underlying loss of tissue, ( 5) intraretinal neovascularization near the fovea, and (6) central intraretinal deposits and plaques. In 63% of cases, the presence of abnormal vessels and a discontinuity of the photoreceptor layer correlated with visual acuity. Conclusions: Ultrahigh-resolution OCT improves visualization of the retinal pathology associated with IJT and allows identification of new features associated with it. Some of these features, such as discontinuity of the photoreceptor layer, were revealed only by UHR OCT.