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Clinical science
Non-proliferative type II macular telangiectasia variant with subfoveal detachment: role of anti-VEGF therapy
  1. George J Manayath1,
  2. Ratnesh Ranjan1,
  3. C K Nagesha2,
  4. Venkatapathy Narendran1
  1. 1Vitreo-Retina Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
  2. 2Vitreo-Retina Services, Aravind Eye Hospital, Pudducherry, Tamil Nadu, India
  1. Correspondence to Dr Ratnesh Ranjan, Vitreo-Retina Services, Aravind Eye Hospital Coimbatore, Coimbatore, TN 641014, India; drratnesh16{at}gmail.com

Abstract

Aims To describe a rare variant of non-proliferative stage of type II macular telangiectasia (MacTel2) with the presence of subfoveal detachment (SFD) and its response to intravitreal antivascular endothelial growth factor (VEGF) therapy.

Methods A retrospective case series of patients diagnosed with a rare variant of non-proliferative MacTel2 (defined as MacTel2 with the presence of SFD on optical coherence tomography (OCT) in the absence of subretinal neovascularisation, confirmed on fluorescein angiography (FA)) over a period of 2 years. Patients were studied with biomicroscopy, OCT and FA. Patients were managed either with observation or anti-VEGF therapy.

Results Twenty eyes of 13 patients, all female with a mean age of 52.2±6.1 years, were diagnosed with this variant of non-proliferative MacTel2. The best-corrected visual acuity at presentation ranged from 20/20 to 20/120. Six eyes were lost to follow-up. Eight eyes were kept under observation for a mean follow-up of 7.3±2.2 months and did not show resolution. Eight eyes underwent anti-VEGF therapy with a mean number of intravitreal injections of 2±1.07 per eye during a mean follow-up of 9.38±5.5 months. All eyes showed complete resolution of SFD, with a visual improvement of ≥1 line of Snellen’s acuity in 87.5% of the eyes.

Conclusion This is the largest series of a variant of non-proliferative MacTel2 with SFD, which shows good anatomical and functional response to anti-VEGF therapy, in comparison to observation alone. Careful evaluation of the OCT images may be helpful in predicting the visual prognosis with anti-VEGF therapy.

  • retina
  • treatment medical

https://doi.org/10.1136/bjophthalmol-2019-315093

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    Footnotes

    • Contributors GJM: conception of the study, data and imaging analysis and manuscript review. RR: data collection and statistical analysis, drafting of the manuscript and revision. CKN: data collection, drafting of the manuscript. VN: conception of the study and critical review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.

    • Author note This study was conducted at the Retina department of Coimbatore and Pudducherry centre of Aravind Eye Hospital & Postgraduate Institute of Ophthalmology.