Comparison of anatomical and visual outcomes following different anti-vascular endothelial growth factor treatments in subretinal neovascular membrane secondary to type 2 proliferative macular telangiectasia

Graefes Arch Clin Exp Ophthalmol. 2020 Jan;258(1):99-106. doi: 10.1007/s00417-019-04520-x. Epub 2019 Nov 25.

Abstract

Purpose: To evaluate central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and visual outcomes following different intravitreal anti-vascular endothelial growth factor (VEGF) treatments in eyes with subretinal neovascular membrane (SRNVM) due to type 2 proliferative macular telangiectasia (Mac Tel 2).

Materials and methods: A total of 38 eyes of 34 patients who underwent intravitreal aflibercept (IVA), intravitreal ranibizumab (IVR), or intravitreal bevacizumab (IVB) injections secondary to SRNVM due to type 2 proliferative MacTel were retrospectively reviewed. The CMT, central macular volume (CMV), best corrected visual acuity (BCVA), and SFCT were evaluated at baseline and at 2 weeks, at 1 month, and at final visits following treatment. Spectral-domain optical coherence tomography and enhanced depth optical coherence tomography were used for the analysis.

Results: The mean age of the patients was 58.34 ± 12.48 years (range, 27-79 years). The mean follow-up time was 15.97 ± 6.79 months (range 5-32 months). The mean BCVA showed a statistically significant increase in each group (< 0.001). There was no statistically significant difference in BCVA changes between groups in follow-up periods. There was a significant decrease in CMT following IVA (326.4 ± 168.03 μm to 236 ± 58.33 μm) and IVB (383.71 ± 156.79 μm to 343.85 ± 146.25 μm) (p < 0.001, p = 0.004, respectively) whereas no significant decrease in CMT was observed following IVR (374.57 ± 124.28 μm to 339.71 ± 126.10 μm) (p = 0.65) between baseline and final visit. The SFCT significantly decreased following both IVB and IVR treatments (p = 0.009, p = 0.03, respectively).

Conclusions: The IVA, IVR, and IVB were found to be effective with regards to anatomical and visual outcomes in proliferative Mac Tel type 2 patients related with SRNVM. Patients receiving both IVA and IVB needed less injections compared to patients who received IVR. Moreover, IVB and IVR lead to significant decrease in SFCT whereas IVA did not show significant effect on SFCT.

Keywords: Anti-vascular endothelial growth factor treatments; Subretinal neovascular membrane; Type 2 proliferative macular telangiectasia.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage
  • Bevacizumab / administration & dosage*
  • Female
  • Fluorescein Angiography / methods
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Macula Lutea / pathology*
  • Male
  • Middle Aged
  • Ranibizumab / administration & dosage*
  • Receptors, Vascular Endothelial Growth Factor / administration & dosage*
  • Recombinant Fusion Proteins / administration & dosage*
  • Retinal Neovascularization / diagnosis
  • Retinal Neovascularization / drug therapy*
  • Retinal Neovascularization / etiology
  • Retrospective Studies
  • Telangiectasis / complications*
  • Telangiectasis / diagnosis
  • Telangiectasis / drug therapy
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Vascular Endothelial Growth Factors / antagonists & inhibitors
  • Visual Acuity*

Substances

  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins
  • Vascular Endothelial Growth Factors
  • aflibercept
  • Bevacizumab
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab