Abstract
Purpose: :
Idiopathic macular telangiectasia (MacTel) Type 2 can cause progressive loss of central vision and marked visual dysfunction in the middle-aged and elderly. Previous studies have shown no benefit from grid laser photocoagulation in the non-proliferative subtype or PDT in the proliferative subtype. Published literature suggests an improvement in visual acuity with intravitreal bevacizumab with Type 2 proliferative MacTel.The purpose of this study is to describe the results of intravitreal ranibizumab therapy in a series of patients with Type 2 MacTel.
Methods: :
The diagnosis of MacTel Type 2 and presence or absence of neovascularisation was confirmed on fundus examination, macular optical coherence tomography, fluorescein and ICG angiography. Treatment with intravitreal ranibizumab (0.5 mg/ 0.05ml) was p.r.n in both non-proliferative and proliferative subtypes, but the latter received, in addition, a loading dose of 3 initial monthly injections.
Results: :
8 eyes of 6 patients (4 male; mean age 78.4 years) were recruited. 5 eyes had proliferative MacTel. Follow-up was between 3 -26 months. Mean number of injections was 4.4. Mean visual acuity at baseline and 3 months was 54.1 (SD ± 17.1) and 57.5 (± 17.0) letters, change of 3.4 (± 6.4) letters. Mean central foveal thickness (CFT) on OCT at baseline and 3 months was 289.6 microns (± 74.5) and 221.8 microns (± 44.0). Mean gain in VA was 6.7 and 1.4 letters in the non-proliferative and proliferative subtypes respectively, while mean reduction in CFT was 77.3 and 62.2 microns respectively. The leakage on FFA reduced or resolved in all cases.
Conclusions: :
Indications early on in the study that there are good results with intravitreal ranibizumab therapy in the non-proliferative subtype of MacTel, need to be substantiated by long term follow-up data. There is good response to intravitreal ranibizumab therapy in Type 2 proliferative MacTel.
Keywords: macula/fovea • degenerations/dystrophies • injection