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N. Patel, H. C. Boldt, J. C. Folk; Treatment of Type IIA Idiopathic Juxtafoveal Telangiectasia With Intravitreal Bevacizumab (Avastin). Invest. Ophthalmol. Vis. Sci. 2008;49(13):4687.
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Type IIA is the most common form of idiopathic juxtafoveal telangiectasia (IJT) and causes slow but progressive vision loss. The vision loss may be associated either with intraretinal cysts and leakage from the telangiectactic vessels or with the development of neovascularization deep within the retina. Our purpose is to investigate the effect of anti-VEGF treatment, namely intravitreal injections of bevacizumab (Avastin), in patients with IJT Type IIA and vision loss.
The results were reviewed of four patients and five eyes who had Type IIA IJT, vision of 20/40 or less, cystic changes or thickening of the fovea measured with ocular coherence tomography (OCT), and were treated with intravitreal bevacizumab. Visual acuity measurements, fluorescein angiography (FA), and OCT were performed on all patients prior to administering treatment. Follow-up evaluation included visual acuity measurement, clinical evaluation, and OCT with or without FA. Visual acuity was measured as Snellen acuity and central OCT measurements were in micrometers as central macular thickness (CMT).
Patients ages ranged between 42-74. All had bilateral asymmetric disease. Patient 1: 48 y.o. male. Leakage from telangiectasia. After 7 injections, vision improved from 20/200 to 20/50 and CMT from 411µ to 170µ.Patient 2: 43 y.o. female; both eyes treated. Leakage from telangiectasia. VA improved from 20/100 to 20/60 in right eye; and 20/200 to 20/100 in left eye. CMT went from 214µ to 184µ in the right eye and 224µ to 205µ in the left eye.Patient 3: 74 y.o. male. Leakage from telangiectasia. Vision improved from 20/125 to 20/100 in left eye with little change in CMT.Patient 4: 42 y.o. female with leakage from both intraretinal neovascularization and telangiectasia. Vision improved from 20/40 to 20/30 after one injection and neovascularization resolved into a small dry scar. CMT went from 213µ to 190µ.
Bevacizumab treatment of Type IIA IJT resulted in modest improvement of the visual acuity in these four patients with IJT Type IIA. Retinal thickening resolved in one patient and cystic changes became less prominent in all patients. In one patient the neovascularization resolved into a dry scar. Further follow-up is necessary to determine if periodic injections of intravitreal bevacizumab are necessary to maintain or improve visual acuity as a useful long-term treatment for this disease.
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