Intravitreal bevacizumab for type 1 idiopathic macular telangiectasia

Abstract

Purpose To evaluate the effect of intravitreal bevacizumab injection for treating type 1 idiopathic macular telangiectasia (IMT). Methods Retrospective case series of five eyes of five male patients with type 1 IMT that were treated with 2-3 injections of intravitreal bevacizumab. Best-corrected visual acuity, foveal thickness obtained by optical coherence tomography, and fluorescein angiography (FA) were monitored over a period of up to 12 months. Results The average follow-up period was 17.0 months (range, 12-21 months). The mean logarithm of the minimal angle of resolution visual acuity was 0.295 at baseline and 0.254 (P ¼ 0.194) and 0.311 (P ¼ 0.461) at 3 and 12 months, respectively, after the initial injection. At 12 months, visual acuity had improved in one eye, remained stable in three eyes, and decreased in one eye. The mean foveal thickness was 479 lm at baseline; at 1 month after the therapy, marked reduction of macular oedema was seen only in one eye. The mean foveal thickness was 418 lm (P ¼ 0.287) and 473 lm (P ¼ 0.482) at 3 and 12 months after the initial injection, respectively. At 12 months, the foveal thickness had decreased by 4100 lm in one eye, but had increased by 4100 lm in two eyes. FA did not show a reduction in late leakage. Conclusions Treatment with intravitreal bevacizumab does not appear to improve visual acuity or retinal oedema in type 1 IMT.

Intravitreal Injection of Bevacizumab to Treat a Macular Edema Caused by Leber’s Miliary Aneurysm

“…Gamulescu et al [1] reported a case of type 1 IMT in whom a single administration of IVB was remarkably effective. In contrast, Takayama et al [3] and Matsumoto and Yuzawa [4] reported that IVB had limited efficacy for type 1 IMT; the courses of their studies resemble our case. These were all small case series, and further investigations are necessary to determine the efficacy of IVB for this type of aneurysm.…”

Macular Oedema Related to Idiopathic Macular Telangiectasia Type 1 Treated with Dexamethasone Intravitreal Implant (Ozurdex)

“…Recently, studies examining the use of intravitreal injections of bevacizumab as a treatment for this condition have found it to be inconsistent in its outcomes [7, 15–18]. Only a few cases have been reported on the use intravitreal injections of triamcinolone acetonide with promising results [5].…”

Pearls and Pitfalls in Diagnosis and Management of Coats Disease

“…Although the literature provides conflicting reports regarding the benefit of intravitreal anti-VEGF drugs in controlling macular edema in Coats disease, clinical experience has been that these agents induce a short-lived response that is often inadequate to prevent disease progression after a single treatment. 44,[60][61][62][63] We lack evidence that young patients have a structurally immature retina or that physiologic revascularization occurs in the adult retina. However, VEGF-A is a critical molecule with multiple bioactivities: processes which involve VEGF-A are listed in the Table 4.…”