Journal List > J Korean Ophthalmol Soc > v.57(12) > 1010478

Kim, Lee, and Park: Combination Therapy with Photodynamic Therapy and Intravitreal Bevacizumab in Idiopathic Macular Telangiectasia Type I

Abstract

Purpose

We investigated the clinical manifestations of combination therapy with photodynamic therapy (PDT) and intravitreal bevacizumab in idiopathic macular telangiectasia type I patients.

Methods

The present study included 7 patients who visited our clinic from May 2008 to February 2011 complaining of decreasing visual acuity and diagnosed as idiopathic macular telangiectasia type I including visible aneurysms at juxtafoveal area and telangiectatic vessels leakage based on fluorescein angiography. Additionally, all patients were treated with combination therapy with PDT and intravitreal bevacizumab.

Results

Visual acuity improved from 0.48 ± 0.14 (log MAR) to 0.18 ± 0.17 (log MAR) after the combination therapy, however, there was no change in intraocular pressure between before (17.9 ± 3.1) and after (16.8 ± 2.3) therapy. After combination therapy, fluorescein angiography showed decreased leakage of telangiectatic vessels and optical coherence tomography showed only minimal intraretinal edema. Central subfield macular thickness decreased from 301.9 ± 50.7 μ m to 193.6 ± 58.8 μ m after the combination therapy.

Conclusions

Combination therapy with intravitreal bevacizumab injection and PDT in patients with idiopathic macular telangiectasia type Ⅰ can result in a rapid decrease of macular edema, which can lead to rapid visual recovery.

References

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Figure 1.
Fluorescein angiography and opti-cal coherence tomography before treatment. Fluorescein angiography of telangiectatic vessels at the early phase (A) and leakage at the late phase (B). (C) Optical coherence tomography of intraretinal edema before combination treatment.
jkos-57-1897f1.tif
Figure 2.
Fluorescein angiography and optical coherence tomography after treatment. Fluorescein angiography of a regression of the telangiectatic vessels (A) and a decreased leakage of telangiectatic vessels at the late phase after combination therapy(B). (C) Optical coherence tomography of minimal intraretinal edema and restored foveal depression after treatment.
jkos-57-1897f2.tif
Table 1.
Clinical characteristics of the patient at presentation
Case Sex/Age B BCVA (log MAR) IOP (mm Hg) Ce ntral subfield macular thickness ( (μ m) Follow-up (months)
1 M/70 1.3 14.2 311 12
2 M/64 0.5 21.0 368 7
3 F/51 0.3 13.7 239 14
4 M/54 0.2 17.9 323 12
5 F/67 0.8 18.2 341 7
6 M/65 0.4 16.0 340 23
7 F/49 0.3 21.5 244 7
Mean   0.48 17.93 301.88 11.13
SD   0.14 3.08 50.69 5.59

BCVA = best corrected visual acuity; log MAR = logarithm of minimal angle resolution; IOP = intraocular pressure; SD = standard deviation.

Table 2.
Clinical outcomes after combined therapy for idiopathic macular telangiectasia type I
  BCVA (log MAR) p-value CSMT (μ m) p-value
Baseline 0.48 ± 0.14   301.9 ± 50.7  
1 month 0.30 ± 0.20 0.06 227.9 ± 53.6 0.02
2 months 0.30 ± 0.21 0.06 211.1 ± 61.3 0.01
6 months 0.18 ± 0.17 0.02 193.6 ± 58.8 0.01

Values are presented as mean ± SD unless otherwise indicated. BCVA = best corrected visual acuity; log MAR = logarithm of minimal angle resolution; CSMT= central subfield macular thickness.

Table 3.
Change of best corrected visual acuity
Visual acuity (log MAR) Initial number (%) Final number (%)
VA ≤ 0.3 3 (42.8) 7 (100)
0.3 < VA ≤ 1.0 3 (42.8) 0 (0)
1.0 < VA 1 (14.4) 0 (0)
Total 7 (100) 7 (100)

Values are presented as n (%). log MAR = logarithm of minimal angle resolution; VA = visual acuity.

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