Combined photodynamic therapy and intravitreal ranibizumab as primary treatment for subretinal neovascular membrane (SRNVM) associated with type 2 idiopathic macular telangiectasia.
BACKGROUND
To report the efficacy of combination photodynamic therapy and intravitreal ranibizumab for juxtafoveal, subretinal neovascular membrane (SRNVM) associated with type 2 idiopathic macular telangiectasia (IMT).


METHODS
A 56-year-old woman with visual loss due to SRNVM secondary to IMT underwent primary treatment with a combination of photodynamic therapy (PDT) and intravitreal ranibizumab (0.5 mg). PDT was done as per the TAP study protocol, except that the laser spot size was same as the greatest linear diameter (GLD) of the lesion. This was followed by intravitreal ranibizumab (0.5 mg), 2 days later.


RESULTS
At the 16-week follow-up, clinical examination revealed regression of the SRNVM, with no evidence of subretinal fluid, exudates or fresh hemorrhages. Visual acuity improved by 2 Snellen lines (from 6/36 to 6/18). Clinical findings were confirmed on FFA and OCT. At the last follow-up at 9 months, the SRNVM remained quiescent and visual acuity stable. No treatment-related adverse effects were noted.


CONCLUSIONS
Combination therapy with PDT and intravitreal ranibizumab appears to be efficacious in the treatment of SRNVM associated with proliferative type 2 IMT.
Rishi
Pukhraj
P
Sankara Nethralaya, Medical Research Foundation, 18, College Road, 600006 Chennai, Tamil Nadu, India. docrishi@yahoo.co.in
Shroff
Daraius
D
Rishi
Ekta
E
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D000069579:Ranibizumab; D012164:Retinal Diseases / Q000150:complications / Q000188:drug therapy*; D015861:Retinal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D013684:Telangiectasis / Q000150:complications / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000069579:Ranibizumab