Idiopathic Macular Telangiectasia Type 1 treated with Intravitreal Ranibizumab and Laser Photocoagulation

Abstract

Introduction: Idiopatic Macular Telangiectasia (IMT) are a rare group of various entities presenting with incompetence, ectasia and/or irregular dilations of the juxtafoveolar capillaries of one or both eyes. Case Report: A 62 year old female with Glaucoma was sent to the Retina Department with a suspected diagnosis of retinal vein occlusion on the left eye (LE). Her best corrected visual acuity (BCVA) was 20/20 in the right eye (RE) and 20/25 in the LE. Slit lamp examination was normal; fundoscopy showed a cup-to-disc relation of 0.6 in the RE with normal macula and a cup-to-disc relation of 0.7 in the LE with multiple perifoveal microaneurysms, inferior temporal hard exudates and edema comproved with macular optical coherence tomography; fluorescein angiography revealed an area of hyperfluorescence with juxtafoveolar telangiectatic vessels located inferiorly and temporally to the fovea, with progressive filling and late active leakage in the LE. The diagnosis of IMT type 1 was made and she was treated with a loading dose of intravitreal injections of ranibizumab followed by a fourth injection because of persistent macular edema. One month after, her BCVA was 20/20 in the LE with improvement of macular edema and macular argon laser photocoagulation was performed. Three months after the laser treatment her LE BCVA was 20/20 with fundoscopy showing small macular hemorrhages and microaneurysms. Conclusion: Macular edema and exudation are the main cause of visual loss in these patients. This case suggests that ranibizumab and laser photocoagulation can be effective in the treatment of type 1 IMT.