PT  - JOURNAL ARTICLE
AU  - Hemal Mehta
AU  - Simone Müller
AU  - Catherine A Egan
AU  - Simona Degli Esposti
AU  - Adnan Tufail
AU  - Dawn A Sim
AU  - Frank G Holz
AU  - Andrew C Browning
AU  - Winfried M Amoaku
AU  - Peter Charbel Issa
AU  - Mark C Gillies
TI  - Natural history and effect of therapeutic interventions on subretinal fluid causing foveal detachment in macular telangiectasia type 2
AID  - 10.1136/bjophthalmol-2016-309237
DP  - 2017 Jul 01
TA  - British Journal of Ophthalmology
PG  - 955--959
VI  - 101
IP  - 7
4099  - http://bjo.bmj.com/content/101/7/955.short
4100  - http://bjo.bmj.com/content/101/7/955.full
SO  - Br J Ophthalmol2017 Jul 01; 101
AB  - Aim To report the natural history of subretinal fluid (SRF) causing foveal detachment in macular telangiectasia type 2 (MacTel) and our experience of therapeutic intervention with intravitreal steroids or antivascular endothelial growth factor inhibitor (anti-VEGF) agents in some cases.Methods Retrospective case series. Three of the MacTel study's largest registries were searched to identify eyes with foveal detachment.Results We identified 7 eyes from 6 exclusively female patients. The prevalence of foveal detachment was low, present in 1.4% of the assessed MacTel population. Age at presentation ranged from 50 to 66 years. Follow-up ranged from 2 to 8 years. There was late-phase leakage on fluorescein angiography from what was presumed to be ectatic capillaries. The SRF fluctuated without a rapid decline in visual acuity in cases that were not treated. When they were, intravitreal anti-VEGF and steroid therapy in general reduced SRF, at least temporarily, but did not halt the gradual long-term decrease in visual acuity. In one case, optical coherence tomography angiography showed significant reduction in the extent of the predominantly deep intraretinal vascular complex 1 month after anti-VEGF therapy.Discussion and conclusions As the natural history of this unusual MacTel phenotype is not characterised by rapid visual decline, intervention with intravitreal anti-VEGF or steroid therapy may not be necessary.