Eighteen-month follow-up of intravitreal bevacizumab in type 2 idiopathic macular telangiectasia.

AIM

To evaluate the effects of intravitreal bevacizumab for non-proliferative type 2 idiopathic macular telangiectasia (type 2 IMT) within a mean follow-up period of 18 months.

METHODS

The authors retrospectively studied six eyes of five patients with type 2 IMT who received two doses of intravitreal bevacizumab (1.5 mg) at a 4-week interval, followed by further applications depending on disease activity. Examinations included biomicroscopy, standardised visual acuity (VA) testing, fluorescein angiography, retinal thickness analysis by optical coherence tomography and fundus-controlled microperimetry.

RESULTS

Mean follow-up time was 18 months (range 16-21 months). The mean VA at four selected time points (1 month after second treatment, 1 month and 3-4 months after last treatment, and at last visit) increased significantly (by 8.8, 6.3, 7.7 and 8.7 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, respectively; all p<or=0.05). Parafoveal leakage in fluorescein angiography and mean central retinal thickness decreased in all eyes following treatment. A rebound effect was observed after 3-4 months, and at the last visit, retinal thickness was increased in selected retinal sectors including the fellow eye.

CONCLUSION

Inhibition of vascular endothelial growth factor (VEGF) by intravitreally injected bevacizumab may lead to functional improvement as well as a transient decrease in leakage and retinal thickness in patients with type 2 IMT. A VEGF-mediated active disease stage in which treatment might be most effective is discussed.