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

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 258; no. 1; pp. 99 - 106
• Main Authors: Karasu, Buğra, Gunay, Betul Onal
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-01-2020; Springer Nature B.V
• Subjects: Acuity; Bevacizumab; Medicine; Medicine & Public Health; Monoclonal antibodies; Ophthalmology; Retinal Disorders; Statistical analysis; Tomography; Vascular endothelial growth factor; Type 2 proliferative macular telangiectasia; Subretinal neovascular membrane; Anti-vascular endothelial growth factor treatments
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-019-04520-x

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.