Abstract
Purpose::
To report on the outcome of intravitreal injection of bevacizumab, an vascular endothelial grouth factor (VEGF) specific inibitor, for the treatment of foveal detachment in type 2A Idiophatic Juxtafoveal Telangiectasis (IJT).
Methods::
Three eyes of two patients type 2A IJT were studied. The presentation was poor vision associated with foveal detachment on the OCT besides the typical angiographic fluorescein leakage. A bevacizumab (0.05ml/1.25mg) intravitreal injection (IVI) was performed and the patients were followed clinically and by OCT. The hight of the retinal detachment at the fovea was assessed manually and the thickness of the flat retina, after the treatment, through the macular map.
Results::
The first postoperative examination was between the 4th an the 5th week. The vision of all patients improved in this period, remaining unchanged up to the last follow-up visit: 24 weeks for patient one, 29 weeks for patient 2 OD and 20 weeks for patient 2 OS. In patient one, OD improved from 20/60to 20/25; the hight of the subretinal fluid on OCT was 116µm and fovea thickness after the treatment was193µm. In patient two, OD improved from 20/60 to 20/20; the hight of the subretinal fluid on OCT was 191µm and fovea thickness after the treatment was184µm and, OS improved from 20/40 to 20/20 the hight of the subretinal fluid on OCT was 174µm and fovea thickness after the treatment was170µm.
Conclusions::
A single bevacizumab IVI is followed by vision amelioration in type 2A IJT eyes complicated with foveal detachment. This improvement is sustained up to 6 months with restoration of the reading vision and patient satisfaction. Based on the outcome of these three eyes we speculate that the development of vessel dysfunction and fluid transudation may be arrested or prevented with the use of IVI bevacizumab. If further controlled studies confirm these findings, intravitreous VEGF specific inhibitors may prove to be of value in preventing photoreceptor degeneration and retinal atrophy due to chronic exsudation in the macula.
Keywords: macula/fovea • drug toxicity/drug effects • imaging/image analysis: clinical