Real-world outcomes of intravitreal anti-vascular endothelial growth factor monotherapy in proliferative type 2 macular
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Real-world outcomes of intravitreal anti-vascular endothelial growth factor monotherapy in proliferative type 2 macular telangiectasia Sagnik Sen 1 & Renu P. Rajan 1 & Sourav Damodaran 1 & Karthik Kumar Arumugam 1 & Naresh Babu Kannan 1 & Kim Ramasamy 1 Received: 14 July 2020 / Revised: 18 October 2020 / Accepted: 2 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background To study the effect of anti-VEGFs in proliferative MacTel 2 Methods Sixty-four eyes of 51 patients of MacTel 2 with subretinal neovascular membrane (SRNVM) undergoing intravitreal anti-VEGF monotherapy at our institution between January 2015 and December 2018 were evaluated for visual acuity, central macular thickness (CMT) and total macular volume (TMV) using optical coherence tomography (OCT). Repeat investigations were performed at the final follow-up. Results Location of SRNVM was foveal (F) in 65.6% eyes and extrafoveal (EF) in 34.4% eyes. Both CMT and TMV were lower significantly at baseline in EF-SRNVM. Fifty-six eyes received intravitreal bevacizumab and 8 eyes received ranibizumab. Average 2.14 ± 1.21 injections (range, 1–6) were administered. After a mean follow-up duration of 16.01 ± 12.96 months, the final visual acuity (VA) improved in 35.9% eyes, reduced in 28.1% and remained unchanged in 35.9% eyes. Significant improvement of VA was seen in F-SRNVM; however, overall, there was no significant improvement in visual acuity. Significant reduction in CMT was seen in F-SRNVM from 391.73 ± 152.45 μm to 293.33 ± 114.77 μm (p < 0.05) while EFSRNVM did not show significant reduction. Total macular volume overall changed significantly from 8.79 ± 1.69 to 8.05 ± 1.27 (p < 0.05) and individually in F- and EF-SRNVM (p < 0.05). Intravitreal bevacizumab and ranibizumab monotherapy both had similar efficacy. Conclusions Anti-VEGF agents can be successfully used to treat proliferative MacTels. Macular volume measurement on OCT may be a useful parameter for evaluating EF-SRNVM and as a prognostic marker of management outcomes. Keywords IJFT . IJT . MacTel . Macular telangiectasia . Anti-VEGF . Ranibizumab . Bevacizumab
Key messages Previous reports with lesser sample size have demonstrated the use of anti-VEGF agents in Mactel 2 subretinal neovascularisation. Our findings demonstrate in a large-scale setting with a significantly higher number of patients that anti-VEGF agents are effective in treating SRNVM in Mactel 2. Extrafoveal CNVM may be difficult to follow-up up by measuring the central macular thickness and the macular volume may be a better measure.
* Renu P. Rajan [email protected] 1
Department of Retina and Vitreous Services, Aravind Eye Hospital, Madurai, India
Introduction Macular telangiectasia is a rare macular disease affecting both sexes and is a frequent cause of moderate vision loss. The exact etiopathogenesis of the disease is still unknown;
Graefes Arch Clin Exp Ophthalmol
however, data from twin studies and bilateral expression of disease make genetics a probable c
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