Intravitreal bevacizumab therapy for idiophatic juxtafoveolar retinal telangiectasis associated with serous macular detachment

Macular telangiectasia type 2 (MacTel) is a relatively rare disease without established treatments. Although MacTel was previously considered a primarily vascular condition, the thinking on its pathogenesis has shifted to it now being considered principally a neurodegenerative disease. This has resulted in a subsequent change in the approach to treatment toward neuro-protection for the non-proliferative phase of this disease. Carotenoid supplementation has had mixed results. Ciliary neurotrophic factor (CNTF) has demonstrated some promising early results, but further study is necessary to determine its actual effect. Some structural improvements have been seen in the non-proliferative phase with oral acetazolamide but without accompanying functional improvement. Anti-vascular endothelial drugs have been studied and not found to have benefit in the non-proliferative phase of disease but have demonstrated significant structural and functional value in the treatment of secondary neovascularization. There is no level I evidence for the various proposed MacTel treatments, and efforts need to be directed toward conducting multicenter randomized trials to better understand possible treatments for this condition. Electronic supplementary material The online version of this article (10.1007/s40123-019-0170-1) contains supplementary material, which is available to authorized users.

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Management of Idiopathic Macular Telangiectasia Type 2

Khodabande

Roohipoor

Zamani

et al. 2019

Ophthalmol Ther

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Non-proliferative type II macular telangiectasia variant with subfoveal detachment: role of anti-VEGF therapy

et al. 2019

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AimsTo describe a rare variant of non-proliferative stage of type II macular telangiectasia (MacTel2) with the presence of subfoveal detachment (SFD) and its response to intravitreal antivascular endothelial growth factor (VEGF) therapy.MethodsA retrospective case series of patients diagnosed with a rare variant of non-proliferative MacTel2 (defined as MacTel2 with the presence of SFD on optical coherence tomography (OCT) in the absence of subretinal neovascularisation, confirmed on fluorescein angiography (FA)) over a period of 2 years. Patients were studied with biomicroscopy, OCT and FA. Patients were managed either with observation or anti-VEGF therapy.ResultsTwenty eyes of 13 patients, all female with a mean age of 52.2±6.1 years, were diagnosed with this variant of non-proliferative MacTel2. The best-corrected visual acuity at presentation ranged from 20/20 to 20/120. Six eyes were lost to follow-up. Eight eyes were kept under observation for a mean follow-up of 7.3±2.2 months and did not show resolution. Eight eyes underwent anti-VEGF therapy with a mean number of intravitreal injections of 2±1.07 per eye during a mean follow-up of 9.38±5.5 months. All eyes showed complete resolution of SFD, with a visual improvement of ≥1 line of Snellen’s acuity in 87.5% of the eyes.ConclusionThis is the largest series of a variant of non-proliferative MacTel2 with SFD, which shows good anatomical and functional response to anti-VEGF therapy, in comparison to observation alone. Careful evaluation of the OCT images may be helpful in predicting the visual prognosis with anti-VEGF therapy.

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Intravitreal bevacizumab therapy for idiophatic juxtafoveolar retinal telangiectasis associated with serous macular detachment

Cited by 2 publications

References 8 publications

Management of Idiopathic Macular Telangiectasia Type 2

Management of Idiopathic Macular Telangiectasia Type 2

Non-proliferative type II macular telangiectasia variant with subfoveal detachment: role of anti-VEGF therapy

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