INTRAVITREAL BEVACIZUMAB FOR TREATMENT OF PROLIFERATIVE AND NONPROLIFERATIVE TYPE 2 IDIOPATHIC MACULAR TELANGIECTASIA

Abstract

In Brief Purpose: To determine the effect of treatment with intravitreal bevacizumab on retinal thickness and visual acuity in the nonproliferative and proliferative forms of Type 2 idiopathic macular telangiectasia. Methods: Retrospective chart review of clinic patients treated with bevacizumab for macular telangiectasia Type 2. Treatment was performed until no further changes were seen after repeated bevacizumab injections. All patients had Snellen visual acuity testing, fundus fluorescein angiography, and measurement of central macular thickness by optical coherence tomography at baseline. Visual acuity and central macular thickness were recorded at follow-up visits. Results: Fourteen eyes of 10 patients were included. In 5 eyes with nonproliferative macular telangiectasia Type 2, average follow-up was 17 months (±7 months), and no eye demonstrated improvement in visual acuity or decrease in central macular thickness at final follow-up compared with baseline. In 9 eyes with proliferative disease, follow-up averaged 17 months (±9 months). At 6 weeks, central macular thickness decreased 63 μm (±58 μm), and acuity improved 1.7 lines (±2 lines). At final follow-up, central macular thickness decreased 48 μm (±89 μm) and acuity improved 1.1 lines (±3 lines). Subretinal neovascularization resolved in eight of nine eyes with proliferative disease after treatment. Conclusion: Bevacizumab did not improve acuity or reduce retinal thickness in nonproliferative macular telangiectasia Type 2 at final follow-up. In proliferative macular telangiectasia Type 2, bevacizumab caused involution of neovascularization and improved visual acuity. Bevacizumab did not sustainably improve vision or reduce retinal thickness in nonproliferative idiopathic macular telangiectasia Type 2. Bevacizumab caused involution of subretinal neovascularization and visual improvement in proliferative macular telangiectasia Type 2. Anti–vascular endothelial growth factor agents are arguably the treatment of choice for macular telangiectasia Type 2 complicated by neovascularization.