Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2

Aim The aim of this study is to evaluate the long-term efficacy of intravitreal bevacizumab (IVB) for eyes with non-proliferative idiopathic macular telangiectasia type 2 (IMT2) and acute vision loss. Methods In this interventional case series, treatment-naive eyes of 13 consecutive patients with IMT2 were included. Eyes with a recent onset of visual loss were treated with 0.04 ml IVB (n = 7). Fellow eyes and eyes of patients without disease progression served as control group (CG) (n = 12). Follow-up examinations included ophthalmoscopy, best-corrected visual acuity (BCVA), optical coherence tomography, and fluorescein angiography (FA). Results Mean follow-up time was 32 +/- 5.7 months in the treatment group (TG) (n = 7) vs 29 +/- 8.8 months in the CG (n = 16). Mean BCVA increased from logMAR 0.47 +/- 0.32 at baseline to logMAR 0.33 +/- 0.31 (P = 0.21) at the last visit in the TG and decreased from logMAR 0.25 +/- 0.39 to logMAR 0.30 +/- 0.40 in the CG (P = 0.17). All patients in the TG showed stabilisation or improvement in vision in Snellen lines in contrast to the CG (chi(2)-test P 0.04). Patients received on average 2.3 +/- 1.3 IVB injections. Mean central millimetre thickness in TG and CG was 260 +/- 83 and 201 +/- 32 mu m at baseline vs 237 +/- 69 and 199 +/- 29 mu m at the last visit, respectively (P = 0.23 and 0.77). FA revealed a significant decrease of the juxtafoveal staining size at month 3 (P = 0.004) and a slight reduction at the last visit (P = 0.11) in the TG. Conclusion Despite an overall moderate effect of IVB treatment, individual patients experience a marked functional and morphological long-term benefit. Eye (2010) 24, 1535-1542; doi:10.1038/eye.2010.113; published online 24 September 2010