Abstract
Purpose :
To assess visual acuity (VA) and central subfield thickness (CST) changes, and catalogue treatments, in eyes with macular telangiectasia over 24 months.
Methods :
A retrospective cohort study using the Corevitas Vestrum Health Retina Database was performed. Eligibility criteria included an initial diagnosis of macular telangiectasia between 2014 and 2023; a minimum of 6-month follow-up; no concurrent diabetic retinopathy, branch or central vein occlusion; patient gender not identified or age < 18 at diagnosis. A previously described ETDRS approximation formula, 85 + 50 x log (Snellen fraction), was used to derive the VA score.
Results :
A total of 19299 eyes with a diagnosis of macular telangiectasia were identified and 9735 were excluded based on eligibility criteria, resulting in 9564 eyes. Mean baseline age was 66.3 years, 63% were female, with right and left eyes equally affected. Mean baseline VA was 66.5 letters (20/50 Snellen equivalent) and mean CST was 260.8 microns (in those 27.1% eyes with documented baseline CST). Follow up extended to at least 6, 12, 18 and 24 months in 9564, 7842, 6594 and 5581 eyes respectively. At 6, 12, 18 and 24 months: 10.8%, 12.7%, 13.8% and 14.9% had undergone at least 1 anti-VEGF treatment with a mean number of treatments of 3.3, 4.9, 6.2 and 7.4 respectively; less than 2% had undergone at least 1 macular laser treatment with a mean number of treatments of 1.3, 1.6, 1.8 and 1.9 respectively; visual acuity showed minimal decline with a mean change of +0.7, 0, -0.3 and -0.9 letters respectively; and CST also showed limited decline with a mean change of -10.7, -6.8, -8.7 and -6.8 microns respectively (in those 11-12% of eyes with documented baseline and follow up CST).
Conclusions :
The typical macular telangiectasia patient presents to retina specialists as a 66-year-old woman with modestly impaired VA and mildly thinned CST bilaterally. Few patients receive macular laser (<2%) or anti-VEGF therapy (<15%) over a 24-month period, consistent with limited therapeutic benefit. The limited declines in VA and CST over 24 months are consistent with the natural course of gradual VA loss, although this may not fully capture the known temporal photoreceptor disruption with symptomatic bilateral nasal scotomas. There remains unmet need for more therapeutic options for this progressive disorder.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.