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G. C. Chang, C. B. Westerfeld, A. M. Lane, J. W. Miller; Intravitreal Bevacizumab (Avastin) in the Treatment of Macular Telangiectasis Type 2 (MacTel 2). Invest. Ophthalmol. Vis. Sci. 2009;50(13):756.
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To study the efficacy of intravitreal bevacizumab (Avastin) in treating macular telangiectasis type 2 (MacTel 2). MacTel 2 is an idiopathic condition in which deep retinal capillary proliferation occurs in the juxtafoveal region of one or both eyes causing central visual distortion or loss. The natural course without treatment in most patients is persistent and/or progressive diminution of central acuity. There is currently no standardized treatment for MacTel 2, although photodynamic therapy (PDT) has been used with variable results. With the advent of anti-vascular endothelial growth factor (anti-VEGF) agents for retinal and choroidal neovascularization, and investigation of its utility for macular edema, we offered off-label use of intravitreal bevacizumab to patients with MacTel 2.
Retrospective case series of 6 eyes (5 patients) treated with intravitreal bevacizumab for macular edema from MacTel 2. Inclusion criteria was based on the presence of unilateral or bilateral abnormal juxtafoveal vessels and macular edema as determined by dilated fundus examination, optical coherence tomography (OCT), and fluorescein angiography (FA). In addition, the eyes did not have prior treatment for MacTel 2. Outcomes were based on ETDRS logMAR best corrected visual acuity (BCVA) before and after one or more injections of bevacizumab (1.25mg/0.05ml).
6 eyes with MacTel 2 received injections of bevacizumab. Mean follow-up time was 8 months (range 5-11 months). Of these 6 eyes, 4 demonstrated improved visual acuity, 1 demonstrated decreased visual acuity, and 1 was unchanged. The mean logMAR visual acuity of these 6 eyes prior to treatment was 0.583 +/- 0.284 (Snellen visual acuity ranged from 20/32 to 20/200). The final mean logMAR visual acuity after one or more injections was 0.400 +/- 0.358 (Snellen 20/20 to 20/160). The findings suggest an overall improvement in mean visual acuity with treatment (paired t-test, 2-tailed; p = 0.09)
Intravitreal bevacizumab may benefit patients with decreased vision from macular edema secondary to MacTel 2. Further study is warranted.
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