Abstract
Introduction
To study the long-term course in patients with idiopathic macular telangiectasia and report the effect of anti VEGF and laser treatment.
Methods
A retrospective case series of 19 patients/38 eyes with symptomatic type 2 idiopathic macular telangiectasia was performed. Six eyes received intravitreal injections of bevacizumab (1–3 injections), four eyes received focal laser treatment. Follow up examinations comprised visual acuity, biomicroscopy, fluorescein angiography and assessment of macular morphology and thickness by time and spectral-domain optical coherence tomography (OCT).
Results
Mean follow-up time was 81 months (range 15–188 months) – the median added up to 80 months. Visual outcome at final visit varied substantially (20/200–20/20). On average visual acuity decreased 1,2 lines (range −0,5 to 6) by 3 years, 2 lines (range −0,5 to 7) by 5 years and 4,1 lines (range 0 to 12) by 10 years. Development of choroidal neovascularisation was observed in only one eye. There was no significant difference in visual acuity between eyes receiving no treatment, intravitreal bevacizumab or laser treatment after 3 and 5 years. Morphological studies by OCT revealed typical changes with retinal atrophy and intraretinal cysts. Visual acuity correlated with the eccentricity of the main manifestation–visual preservation was associated with mainly extrafoveal disease manifestation.
Discussion
Type 2 idiopathic macular telangiectasia is a chronic, often slowly progressing macular disease leading to retinal atrophy and visual impairment over decades. Thorough knowledge about the long term course of this disease is necessary to evaluate possible therapeutic options in the long run.
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References
Charbel Issa P, Gillies MC, Chew EY, Bird AC, Heeren TF, Peto T, Holz FG, Scholl HP (2012) Macular telangiectasia type 2. Prog Retin Eye Res epub ahead doi:10.1016/j.preteyeres.2012.11.002
Charbel Issa P, Holz FG, Scholl HP (2007) Findings in fluorescein angiography and optical coherence tomography after intravitreal bevacizumab in type 2 idiopathic macular telangiectasia. Ophthalmology 114:1736–1742
Surguch V, Gamulescu MA, Gabel VP (2007) Optical coherence tomography findings in idiopathic juxtafoveal retinal telangiectasis. Graefes Arch Clin Exp Ophthalmol 245:783–788
Gaudric A, Ducos de Lahitte G, Cohen SY, Massin P, Haouchine B (2006) Optical coherence tomography in group 2A idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol 124:1410–1419
Helb HM, Charbel Issa P, van der Veen RL, Berendschot TT, Scholl HP, Holz FG (2008) Abnormal macular pigment distribution in type 2 idiopathic macular telangiectasia. Retina 28:808–816
Charbel Issa P, Finger RP, Helb HM, Holz FG, Scholl HP (2008) A new diagnostic approach in patients with type 2 macular telangiectasia: confocal reflectance imaging. Acta Ophthalmol 86:464–465
Charbel Issa P, Helb HM, Rohrschneider K, Holz FG, Scholl HP (2007) Microperimetric assessment of patients with type 2 idiopathic macular telangiectasia. Investig Ophthalmol Vis Sci 48:3788–3795
Finger RP, Charbel Issa P, Fimmers R, Holz FG, Rubin GS, Scholl HP (2009) Reading performance is reduced by parafoveal scotomas in patients with macular telangiectasia type 2. Investig Ophthalmol Vis Sci 50:1366–1370
Yannuzzi LA, Bardal AM, Freund KB, Chen KJ, Eandi CM, Blodi B (2006) Idiopathic macular telangiectasia. Arch Ophthalmol 124:450–460
Park DW, Schatz H, McDonald HR, Johnson RN (1997) Grid laser photocoagulation for macular edema in bilateral juxtafoveal telangiectasis. Ophthalmology 104:1838–1846
De Lahitte GD, Cohen SY, Gaudric A (2004) Lack of apparent short-term benefit of photodynamic therapy in bilateral, acquired, parafoveal telangiectasis without subretinal neovascularization. Am J Ophthalmol 138:892–894
Charbel Issa P, Finger RP, Holz FG, Scholl HP (2008) Eighteen-month follow-up of intravitreal bevacizumab in type 2 idiopathic macular telangiectasia. Br J Ophthalmol 92:941–945
Charbel Issa P, Scholl HP, Holz FG (2007) Intravitreal bevacizumab for the treatment of type 2 idiopathic macular teleangiectasis. Retin Case Brief Rep 1:189–191
Kovach JL, Rosenfeld PJ (2009) Bevacizumab (avastin) therapy for idiopathic macular telangiectasia type II. Retina 29:27–32
Matsumoto Y, Yuzawa M (2010) Intravitreal bevacizumab therapy for idiopathic macular telangiectasia. Jpn J Ophthalmol 54:320–324
Matt G, Sacu S, Ahlers C, Schutze C, Dunavoelgyi R, Prager F, Pruente C, Schmidt-Erfurth U (2010) Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2. Eye (Lond) 24:1535–1541
Charbel Issa P, Finger RP, Kruse K, Baumuller S, Scholl HP, Holz FG (2011) Monthly ranibizumab for nonproliferative macular telangiectasia type 2: a 12-month prospective study. Am J Ophthalmol 151:876–886
Roller AB, Folk JC, Patel NM, Boldt HC, Russell SR, Abramoff MD, Mahajan VB (2011) Intravitreal bevacizumab for treatment of proliferative and nonproliferative type 2 idiopathic macular telangiectasia. Retina 31:1848–1855
Toy BC, Koo E, Cukras C, Meyerle CB, Chew EY, Wong WT (2012) Treatment of nonneovascular idiopathic macular telangiectasia type 2 with intravitreal ranibizumab: results of a phase II clinical trial. Retina 32:996–1006
Wolf-Schnurrbusch UE, Ceklic L, Brinkmann CK, Iliev ME, Frey M, Rothenbuehler SP, Enzmann V, Wolf S (2009) Macular thickness measurements in healthy eyes using six different optical coherence tomography instruments. Investig Ophthalmol Vis Sci 50:3432–3437
Gass JD, Blodi BA (1993) Idiopathic juxtafoveolar retinal telangiectasis. Update of classification and follow-up study. Ophthalmology 100:1536–1546
Gass JD, Oyakawa RT (1982) Idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol 100:769–780
Watzke RC, Klein ML, Folk JC, Farmer SG, Munsen RS, Champfer RJ, Sletten KR (2005) Long-term juxtafoveal retinal telangiectasia. Retina 25:727–735
Shukla D, Gupta SR, Neelakantan N, Tiwari S, Gupta S, Patwardhan AR, Soubhya TB (2012) Type 2 idiopathic macular telangiectasia. Retina 32:265–274
Chew EY (2006) Parafoveal teleaniectasis. In: Ryan SJ, Hinton DR, Schachat AP, Wilkinson CP (eds) Retina. Mosby, St. Louis, pp 1409–1415
Charbel Issa P, Troeger E, Finger R, Holz FG, Wilke R, Scholl HP (2010) Structure-function correlation of the human central retina. PLoS One 5:e12864
Clemons TE, Gillies MC, Chew EY, Bird AC, Peto T, Figueroa MJ, Harrington MW (2010) Baseline characteristics of participants in the natural history study of macular telangiectasia (MacTel) MacTel Project Report No. 2. Ophthalmic Epidemiol 17:66–73
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Meyer-ter-Vehn, T., Herzog, S., Schargus, M. et al. Long-term course in type 2 idiopathic macular telangiectasia. Graefes Arch Clin Exp Ophthalmol 251, 2513–2520 (2013). https://doi.org/10.1007/s00417-013-2346-z
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DOI: https://doi.org/10.1007/s00417-013-2346-z