Abstract
Purpose
To evaluate central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and visual outcomes following different intravitreal anti-vascular endothelial growth factor (VEGF) treatments in eyes with subretinal neovascular membrane (SRNVM) due to type 2 proliferative macular telangiectasia (Mac Tel 2).
Materials and methods
A total of 38 eyes of 34 patients who underwent intravitreal aflibercept (IVA), intravitreal ranibizumab (IVR), or intravitreal bevacizumab (IVB) injections secondary to SRNVM due to type 2 proliferative MacTel were retrospectively reviewed. The CMT, central macular volume (CMV), best corrected visual acuity (BCVA), and SFCT were evaluated at baseline and at 2 weeks, at 1 month, and at final visits following treatment. Spectral-domain optical coherence tomography and enhanced depth optical coherence tomography were used for the analysis.
Results
The mean age of the patients was 58.34 ± 12.48 years (range, 27–79 years). The mean follow-up time was 15.97 ± 6.79 months (range 5–32 months). The mean BCVA showed a statistically significant increase in each group (< 0.001). There was no statistically significant difference in BCVA changes between groups in follow-up periods. There was a significant decrease in CMT following IVA (326.4 ± 168.03 μm to 236 ± 58.33 μm) and IVB (383.71 ± 156.79 μm to 343.85 ± 146.25 μm) (p < 0.001, p = 0.004, respectively) whereas no significant decrease in CMT was observed following IVR (374.57 ± 124.28 μm to 339.71 ± 126.10 μm) (p = 0.65) between baseline and final visit. The SFCT significantly decreased following both IVB and IVR treatments (p = 0.009, p = 0.03, respectively).
Conclusions
The IVA, IVR, and IVB were found to be effective with regards to anatomical and visual outcomes in proliferative Mac Tel type 2 patients related with SRNVM. Patients receiving both IVA and IVB needed less injections compared to patients who received IVR. Moreover, IVB and IVR lead to significant decrease in SFCT whereas IVA did not show significant effect on SFCT.
Similar content being viewed by others
References
Gass JD, Oyakawa RT (1982) Idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol 100:769–780
Wu L, Evans T, Arevalo JF (2013) Idiopathic macular telangiectasia type 2 (idiopathic juxtafoveolar retinal telangiectasis type 2A, Mac Tel 2). Surv Ophthalmol 58:536–559
Gass JD, Blodi BA (1993) Idiopathic juxtafoveolar retinal telangiectasis: Update of classification and follow-up study. Ophthalmology 100:1536–1546
Yannuzzi LA, Bardal AM, Freund KB et al (2006) Idiopathic macular telangiectasia. Arch Ophthalmol 124:450–460
Eliassi-Rad B, Green WR (1999) Histopathologic study of presumed parafoveal telangiectasis. Retina 19:332–335
Hirano Y, Yasukawa T, Usui Y, Nozaki M, Ogura Y (2010) Indocyanine green angiography-guided laser photocoagulation combined with sub-Tenon’s capsule injection of triamcinolone acetonide for idiopathic macular telangiectasia. Br J Ophthalmol 94:600–605
Chopdar A (1978) Retinal telangiectasis in adults: fluorescein angiographic findings and treatment by argon laser. Br J Ophthalmol 62:243–250
Cakir M, Kapran Z, Basar D et al (2006) Optical coherence tomography evaluation of macular edema after intravitreal triamcinolone acetonide in patients with parafoveal telangiectasis. Eur J Ophthalmol 16:711–717
Li KK, Goh TY, Parsons H, Chan WM, Lam DS (2005) Use of intravitreal triamcinolone acetonide injection in unilateral idiopathic juxtafoveal telangiectasis. Clin Exp Ophthalmol 33:542–544
Martinez JA (2003) Intravitreal triamcinolone acetonide for bilateral acquired parafoveal telangiectasis. Arch Ophthalmol 121:1658–1659
Terauchi G, Matsumoto CS, Shinoda K et al (2014) Pars plana vitrectomy combined with focal endolaser photocoagulation for idiopathic macular telangiectasia. Case Rep Med 2014:786578
Ciarnella A, Verrilli S, Fenicia V et al (2012) Intravitreal ranibizumab and laser photocoagulation in the management of idiopathic juxtafoveolar retinal telangiectasia type 1: a case report. Case Rep Ophthalmol 3:298–303
Rouvas A, Malamos P, Douvali M, Ntouraki A, Markomichelakis NN (2013) Twelve months of follow-up after intravitreal injection of ranibizumab for the treatment of idiopathic parafoveal telangiectasia. Clin Ophthalmol 7:1357–1362
Shibeeb O, Vaze A, Gillies M, Gray T (2014) Macular oedema in idiopathic macular telangiectasia type1 responsive to aflibercept but not bevacizumab. Case Rep Ophthalmol Med 2014:219792
Gamulescu MA, Walter A, Sachs H, Helbig H (2008) Bevacizumab in the treatment of idiopathic macular telangiectasia. Graefes Arch Clin Exp Ophthalmol 246:1189–1193
Koay CL, Chew FL, Visvaraja S (2011) Bevacizumab and type 1 idiopathic macular telangiectasia. Eye (Lond) 25:1663–1665
Matsumoto Y, Yuzawa M (2010) Intravitreal bevacizumab therapy for idiopathic macular telangiectasia. Jpn J Ophthalmol 54:320–324
Moon BG, Kim YJ, Yoon YH, Lee JY (2012) Use of intravitreal bevacizumab injections to treat type 1 idiopathic macular telangiectasia. Graefes Arch Clin Exp Ophthalmol 250:1697–1699
Moon SJ, Berger AS, Tolentino MJ, Misch DM (2007) Intravitreal bevacizumab for macular edema from idiopathic juxtafoveal retinal telangiectasis. Ophthalmic Surg Lasers Imaging 38:164–166
Takayama K, Ooto S, Tamura H et al (2010) Intravitreal bevacizumab for type 1 idiopathic macular telangiectasia. Eye (Lond) 24:1492–1497
Yannuzzi LA, Bardal AM, Freund KB, Chen KJ, Eandi CM, Blodi B (2012) Idiopathic macular telangiectasia. 2006. Retina 32(Suppl 1):450–460
Newman E, Reichenbach A (1996) The Muller cell: a functional element of the retina. Trends Neurosci 19:307–312
Tout S, Chan-Ling T, Hollander H, Stone J (1993) The role of Muller cells in the formation of the blood-retinal barrier. Neuroscience 55:291–301
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, 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
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
Maia OO Jr, Bonanomi MT, Takahashi WY, Nascimento VP, Takahashi BS (2007) Intravitreal bevacizumab for foveal detachment in idiopathic perifoveal telangiectasia. Am J Ophthalmol 144:296–299
Matt G, Sacu S, Ahlers C, Schutze C, Dunavoelgyi R, Prager F et al (2010) Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2. Eye (Lond) 24:1535–1541
Raza S, Toklu Y, Anayol MA, Şimşek Ş, Özkan B, Altıntaş AK (2011) Comparison between efficacy of triamcinolone acetonide and bevacizumab in a case with type 2A idiopathic parafoveal telangiectasia. Turk J Ophthalmol 41:6–9
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
Veloso CE, Vianna RN, Pelayes DE, Nehemy MB (2013) Intravitreal bevacizumab for type 2 idiopathic macular telangiectasia. Ophthalmic Res 49:205–208
Narayanan R, Majji AB, Hussain N et al (2008) Characterization of idiopathic macular telangiectasia type 2 by fundus fluorescein angiography in Indian population. Eur J Ophthalmol 18:587–590
Nalcı H, Şermet F, Demirel S, Özmert E (2017) Optical Coherence Tomography Angiography Findings in Type-2 Macular Telangiectasia. Turk J Ophthalmol 47(5):279–284. https://doi.org/10.4274/tjo.68335
Wu L (2015) When is macular edema not macular edema? An update on macular telangiectasia type 2. Taiwan J Ophthalmol 5(4):149–155. https://doi.org/10.1016/j.tjo.2015.09.001
Narayanan R, Chhablani J, Sinha M et al (2012) Efficacy of anti-vascular endothelial growth factor therapy in subretinal neovascularization secondary to macular telangiectasia type 2. Retina 32:2001–2005
Mandal S, Venkatesh P, Abbas Z et al (2007) Intravitreal bevacizumab (Avastin) for subretinal neovascularization secondary to type 2A idiopathic juxtafoveal telangiectasia. Graefes Arch Clin Exp Ophthalmol 245:1825–1829
Khodabande A, Roohipoor R, Zamani J et al (2019) Management of Idiopathic Macular Telangiectasia Type 2. Ophthalmol Therapy 8(2):155–175
Karagiannis D, Georgalas I, Ladas I, Eustratios P, Mitropoulos P (2009) A case of subretinal neovascularization treated with intravitreal ranibizumab in a patient with idiopathic juxtafoveal retinal telangiectasis. Clin Interv Aging 4:63–65
Papadopoulos Z (2019) Aflibercept: A review of its effect on the treatment of exudative age-related macular degeneration. Eur J Ophthalmol 29(4):368–378
Davidorf FH, Pressman MD, Chambers RB (2004) Juxtafoveal telangiectasis-a name change? Retina 24(3):474–478
Gass JD (2003) Chorioretinal anastomosis probably occurs infrequently in type 2A idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol 121(9):1345–1346
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Karasu, B., Gunay, B.O. Comparison of anatomical and visual outcomes following different anti-vascular endothelial growth factor treatments in subretinal neovascular membrane secondary to type 2 proliferative macular telangiectasia. Graefes Arch Clin Exp Ophthalmol 258, 99–106 (2020). https://doi.org/10.1007/s00417-019-04520-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-019-04520-x