Long-Term Juxtafoveal Retinal Telangiectasia

Watzke, Robert C.; Klein, Michael L.; Folk, James C.; Farmer, Samuel G.; Munsen, Richard; Champfer, Robert J.; Sletten, Karin R.

doi:10.1097/00006982-200509000-00007

Cited by 39 publications

(28 citation statements)

References 13 publications

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“…2 Especially the late stage of IMT2 in the natural course is reported to have a poor prognosis because of the development of retinal and epiretinal scars. 8 In our study, one patient in the TG developed a lamellar hole. The foveal atrophic changes within the neurosensory retina in IMT2 may predispose the development of macular holes.…”

Section: Discussionmentioning

confidence: 49%

Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2

Matt

Sacu

Ahlers

et al. 2010

Eye

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Section: Discussionmentioning

confidence: 49%

Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2

Matt

Sacu

Ahlers

et al. 2010

Eye

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“…A long-term natural history study for MacTel type 2 by Watzke et al [27 ]states that 3 out of 4 patients have a poor prognosis for functional central vision. Therefore, this progressive bilateral disease subjects the patients to a substantial loss of vision-related quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, the underlying pathology of MacTel type 2 is not known, and currently no effective treatment exists to prevent the progressive loss of central vision that is seen in the natural course of the disease [3,27]. …”

Section: Introductionmentioning

confidence: 99%

Reduced-Fluence Photodynamic Therapy Combined with Ranibizumab for Nonproliferative Macular Telangiectasia Type 2

Zehetner¹,

Haas²,

B³

et al. 2013

Ophthalmologica

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Purpose: To report the efficacy of reduced-fluence photodynamic therapy (PDT) combined with intravitreal ranibizumab for the treatment of nonproliferative macular telangiectasia (MacTel) type 2. Methods: Noncomparative, interventional, retrospective case series; 5 eyes of 4 patients were studied. Patients were treated with reduced-fluence PDT and intravitreal ranibizumab within 24 h. After initial treatment, follow-up was at least 12 months in all patients. Results: At baseline median logMAR (logarithm of the minimal angle of resolution) best-corrected visual acuity (BCVA) was 1.0 (range, 1.0-0.3). At 3 months of follow-up vision increased in 3 out of 5 eyes and median BCVA was 0.4 (range, 1.0-0.2). The gain of BCVA ranged from 6 lines to 1 line. Visual acuity remained stable in the other 2 study eyes. No eyes lost vision at 3 months of follow-up. At 12 months of follow-up median logMAR BCVA was 0.7 (range, 1.3-0.3). Two eyes had maintained their gain in BCVA compared to baseline. Two eyes lost vision compared to baseline and 1 eye showed unchanged visual acuity at 12 months of follow-up. Conclusion: A combination therapy with reduced-fluence PDT and intravitreal ranibizumab might be a valuable treatment option for eyes with progressive vision loss due to nonproliferative MacTel type 2.

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“…(Chopdar, 1978;Friedman et al, 1993;Gass and Blodi, 1993;Hutton et al, 1978;Kiraly and Nasemann, 1995;Lowe et al, 1998;Park et al, 1997;Stoffelns et al, 2010;Watzke et al, 2005) Obsolete due to side effects (Gass and Blodi, 1993;Lee, 1996;Watzke et al, 2005) Photodynamic ( Alldredge and Garretson, 2003;Cakir et al, 2006;Maguluri et al, 2007;Maia Junior et al, 2006;Martinez, 2003;Wu et al, 2008) --+ Indocyanine green-mediated photothrombosis (Arevalo et al, 2007) Posterior juxtascleral administration of steroids…”

Section: Abbreviationsmentioning

confidence: 99%

Macular Telangiectasia Type 2

Heeren

Holz

Issa

2013

Microperimetry and Multimodal Retinal Imaging

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Macular telangiectasia type 2 is a bilateral disease of unknown cause with characteristic alterations of the macular capillary network and neurosensory atrophy. Its prevalence may be underestimated and has recently been shown to be as high as 0.1% in persons 40 years and older. Biomicroscopy may show reduced retinal transparency, crystalline deposits, mildly ectatic capillaries, blunted venules, retinal pigment plaques, foveal atrophy, and neovascular complexes. Fluorescein angiography shows telangiectatic capillaries predominantly temporal to the foveola in the early phase and a diffuse hyperfluorescence in the late phase. High-resolution optical coherence tomography (OCT) may reveal disruption of the photoreceptor inner segment-outer segment border, hyporeflective cavities at the level of the inner or outer retina, and atrophy of the retina in later stages. Macular telangiectasia type 2 shows a unique depletion of the macular pigment in the central retina and recent therapeutic trials showed that such depleted areas cannot re-accumulate lutein and zeaxanthin after oral supplementation. There have been various therapeutic approaches with limited or no efficacy. Recent clinical trials with compounds that block vascular endothelial growth factor (VEGF) have established the role of VEGF in the pathophysiology of the disease, but have not shown significant efficacy, at least for the nonneovascular disease stages. Recent progress in structure-function correlation may help to develop surrogate outcome measures for future clinical trials.In this review article, we summarize the current knowledge on macular telangiectasia type 2, including the epidemiology, the genetics, the clinical findings, the staging and the differential diagnosis of the disease. Findings using retinal imaging are discussed, including fluorescein angiography, OCT, adaptive optics imaging, confocal scanning laser ophthalmoscopy, and fundus autofluorescence, as are the findings using visual function testing including visual acuity and fundus-controlled microperimetry. We provide an overview of the therapeutic approaches for both non-neovascular and neovascular disease stages and provide a perspective of future directions including animal models and potential therapeutic approaches.

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Long-Term Juxtafoveal Retinal Telangiectasia

Abstract: IJRT prognosis depends on type and clinical features. Long-term prognosis for central vision is poor.

Cited by 39 publications

References 13 publications

Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2

Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2

Reduced-Fluence Photodynamic Therapy Combined with Ranibizumab for Nonproliferative Macular Telangiectasia Type 2

Macular Telangiectasia Type 2

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