Findings in Fluorescein Angiography and Optical Coherence Tomography after Intravitreal Bevacizumab in Type 2 Idiopathic Macular Telangiectasia

Purpose: To report the short-term effects of intravitreal bevacizumab in patients with type 2 idiopathic macular telangiectasia (IMT). Design: Noncomparative, interventional, retrospective case series. Participants: Seven eyes of 6 patients with type 2 IMT were studied. Methods: Patients received 2 doses of intravitreal bevacizumab (1.5 mg) at 4-week intervals. Serial examinations included standardized Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity (VA), fluorescein angiography, and optical coherence tomography (OCT). Main Outcome Measures: Assessments of OCT retinal thickness, angiographic characteristics, and VA were performed at baseline and at 4 and 8 weeks after the initial treatment. Results: A mean increase in VA of 8 ETDRS letters at 8 weeks was found (P<0.05). Visual acuity improved by more than 15 letters in 1 patient and by 10 to 15 letters in 2 patients and remained stable (-1 to +10 letters) in another 4 patients compared with baseline. All patients showed a reduction in extension and intensity of late-stage parafoveal hyperfluorescence on fluorescein angiography. In OCT imaging, mean retinal thickness showed a reduction in the foveal and in the parafoveal zones (P<0.01). The most pronounced effect (mean decrease, 22μm) was in the parafoveal temporal zone. No significant ocular or systemic side effects were observed. Conclusions: Short-term results indicate that inhibition of vascular endothelial growth factor by intravitreal bevacizumab is associated with a decrease in retinal thickness and a reduction in angiographic leakage in type 2 IMT. Furthermore, intravitreal bevacizumab may improve VA in affected patients.