POOR LONG-TERM OUTCOME OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY IN NONPROLIFERATIVE MACULAR TELANGIECTASIA TYPE 2.
OBJECTIVE
To investigate long-term effects after intravitreal inhibition of vascular endothelial growth factor in nonproliferative macular telangiectasia type 2.


METHODS
Nine patients with macular telangiectasia type 2 treated with 12 monthly intravitreal ranibizumab injections in 1 eye were investigated again after a mean follow-up of 6.0 ± 0.4 years. Functional assessment included best-corrected visual acuity and microperimetry testing. Morphologic investigations included optical coherence tomography imaging and fluorescein angiography.


RESULTS
Mean visual acuity at baseline was similar in treated and control eyes (both 20/50; range: 20/32-20/125 in the treated eyes and 20/25-20/100 in the untreated eyes). None of the eyes had a neovascular membrane or a paracentral scotoma. At the last follow-up, more eyes of the treatment group had lost 2 or more lines on best-corrected visual acuity testing (4 vs. 1) and more eyes had developed an absolute paracentral scotoma (7 vs. 2). A secondary neovascular membrane had formed in four of the treated and in none of the untreated eyes.


CONCLUSIONS
Vascular endothelial growth factor inhibition with monthly dosing over 1 year had no beneficial effect 5 years after cessation of therapy. The worse outcome in the treated eyes may be due to selection bias, small sample size, or a potential adverse effect of vascular endothelial growth factor inhibition in a degenerative, primarily nonvascular disease as macular telangiectasia type 2.
Department of Ophthalmology, University of Bonn, Bonn, Germany.
Elke H
EH
Kupitz
Tjebo F C
TF
Heeren
Frank G
FG
Holz
Peter
P
Charbel Issa
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D013684:Telangiectasis / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab