Anti-Vascular Endothelial Growth Factor Treatment for Proliferative Macular Telangiectasia Type 2

Abstract

Idiopathic macular telangiectasia type 2 (IMT 2), is the most common type of a heterogeneous group of disorders, characterized by telangiectatic alterations of the juxtafoveolar capillary network. Vision loss is due to retinal atrophy and subretinal neovascularization (SRN). Here, we report the outcomes of intravitreal anti-vascular endothelial growth factor injections, bevacizumab or ranibizumab, in four cases with proliferative IMT 2. Baseline best corrected visual acuity (VA) ranged from 20/50 to 20/100. Follow-up time ranged from 12 months to 24 months. One of four patients received one injection, two patients received three injections, and one patient received seven injections. VA improved in three eyes (≥1 line improvement) and decreased in one eye (≥1 line decrease) over time. Final acuity ranged from 20/30 to 20/100. There were no cases of leakage after the cessation of treatment. SRN, which is a complication of IMT 2, should be recognized and treated accordingly.

Keywords: Anti-Vascular Endothelial Growth Factor; Bevacizumab; Ranibizumab; Retinal Telangiectasia.

Figure 1

The color fundus of the left eye (case 1) showed the clinical appearance of idiopathic macular telangiectasia type 2 complicated by subretinal neovascularization before (a), fundus fluorescein angiography revealed a subfoveal classic choroidal neovascularization associated with leakage before therapy (b), optical coherence tomography detected a high reflective area located subfoveally and associated with intra- and sub-retinal fluid collection before therapy (c), and after seven intravitreal bevacizumab injections (d), and reduced leakage after injections (e). Optical coherence tomography confirmed the absence of intra- or sub-retinal fluid and a significant reduction in retinal thickness in the macula (f)