Real-world outcomes of intravitreal anti-vascular endothelial growth factor monotherapy in proliferative type 2 macular telangiectasia.

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 EF-SRNVM 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.

• Authors: Sagnik Sen, Renu P Rajan, Sourav Damodaran, Karthik Kumar Arumugam, Naresh Babu Kannan, Kim Ramasamy
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 259 Issue 5 Pg. 1135-1143 (May 2021) ISSN: 1435-702X [Electronic] Germany
• PMID: 33201355 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Vascular Endothelial Growth Factor A
• Bevacizumab
• Ranibizumab

Topics

• Angiogenesis Inhibitors (therapeutic use)
• Bevacizumab (therapeutic use)
• Follow-Up Studies
• Humans
• Intravitreal Injections
• Ranibizumab (therapeutic use)
• Telangiectasis (drug therapy)
• Tomography, Optical Coherence
• Treatment Outcome
• Vascular Endothelial Growth Factor A