title: Natural history and effect of therapeutic interventions on subretinal fluid causing foveal detachment in macular telangiectasia type 2.
abstract: To report the natural history of subretinal fluid (SRF) causing foveal detachment in macular telangiectasia type 2 (MacTel) and our experience of therapeutic intervention with intravitreal steroids or antivascular endothelial growth factor inhibitor (anti-VEGF) agents in some cases.
  
  
  
  Retrospective case series. Three of the MacTel study's largest registries were searched to identify eyes with foveal detachment.
  
  
  
  We identified 7 eyes from 6 exclusively female patients. The prevalence of foveal detachment was low, present in 1.4% of the assessed MacTel population. Age at presentation ranged from 50 to 66 years. Follow-up ranged from 2 to 8 years. There was late-phase leakage on fluorescein angiography from what was presumed to be ectatic capillaries. The SRF fluctuated without a rapid decline in visual acuity in cases that were not treated. When they were, intravitreal anti-VEGF and steroid therapy in general reduced SRF, at least temporarily, but did not halt the gradual long-term decrease in visual acuity. In one case, optical coherence tomography angiography showed significant reduction in the extent of the predominantly deep intraretinal vascular complex 1 month after anti-VEGF therapy.
  
  
  
  As the natural history of this unusual MacTel phenotype is not characterised by rapid visual decline, intervention with intravitreal anti-VEGF or steroid therapy may not be necessary.
authors: Macular Research Group, Save Sight Institute, University of Sydney, Sydney, Australia.|Medical Retina Department, Moorfields Eye Hospital NHS Trust, London, UK.
authors: Hemal
authors: H
authors: Mehta
authors: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors: Simone
authors: S
authors: Müller
authors: Medical Retina Department, Moorfields Eye Hospital NHS Trust, London, UK.
authors: Catherine A
authors: CA
authors: Egan
authors: Medical Retina Department, Moorfields Eye Hospital NHS Trust, London, UK.
authors: Simona
authors: S
authors: Degli Esposti
authors: Medical Retina Department, Moorfields Eye Hospital NHS Trust, London, UK.
authors: Adnan
authors: A
authors: Tufail
authors: Medical Retina Department, Moorfields Eye Hospital NHS Trust, London, UK.
authors: Dawn A
authors: DA
authors: Sim
authors: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors: Frank G
authors: FG
authors: Holz
authors: Division of Ophthalmology and Visual Sciences, University of Nottingham, Queen's Medical Centre, UK.
authors: Andrew C
authors: AC
authors: Browning
authors: Division of Ophthalmology and Visual Sciences, University of Nottingham, Queen's Medical Centre, UK.
authors: Winfried M
authors: WM
authors: Amoaku
authors: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors: Peter
authors: P
authors: Charbel Issa
authors: Macular Research Group, Save Sight Institute, University of Sydney, Sydney, Australia.
authors: Mark C
authors: MC
authors: Gillies
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000068258:Bevacizumab / Q000008:administration & dosage*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D058471:Subretinal Fluid / Q000000981:diagnostic imaging / Q000187:drug effects*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: Macula; Retina; Treatment other