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Savitha Madhusudhan, Heinrich Heimann, Nicholas Beare, Simon Harding; Intravitreal Ranibizumab Therapy In Mactel. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4529.
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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.
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.
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.
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.
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