Bevacizumab in the treatment of idiopathic macular telangiectasia.

BACKGROUND: To describe functional and morphological long-term follow-up results in patients with idiopathic macular telangiectasia (IMT) treated with intravitreal bevacizumab.

METHODS: Retrospective case series of three consecutive male patients with IMT who were treated with intravitreal bevacizumab injections. Best corrected visual acuity (BCVA) as well as fluorescein angiography (FA) and optical coherence tomography (OCT) were monitored over the period of up to 12 months.

RESULTS: Single intravitreal bevacizumab injection resulted in a marked increase in BCVA from 20/50 to 20/20 in the patient with type 1 (aneurysmal) IMT during the first 4 weeks. Late-phase leakage on FA and cystoid macular oedema on OCT decreased significantly. This was sustained over the whole follow-up period of 12 months. In contrast, in the two patients with type 2 (perifoveal) IMT, leakage on FA decreased likewise, but this was not accompanied by an increase in BCVA despite triple injections. Small cystic changes seen on OCT remained unchanged.

CONCLUSION: Patients with type 1 IMT with pronounced macular oedema on OCT may benefit from intravitreal bevacizumab injections, showing functional as well as morphological improvement, while patients with type 2 IMT with minimal cystic changes on OCT do not show functional improvement despite repeated injections.