Twelve months of follow-up after intravitreal injection of ranibizumab for the treatment of idiopathic parafoveal telangiectasia

Abstract

Alexandros Rouvas,1 Panagiotis Malamos,2 Maria Douvali,1 Amalia Ntouraki,1 Nikos N Markomichelakis1 12nd Department of Ophthalmology, Medical School of Athens University, Athens, Greece; 2Department of Ophthalmology, NHS, “G Gennimatas” General Hospital, Athens, Greece Aims: To report the anatomic and functional outcomes of intravitreal ranibizumab in idiopathic parafoveal telangiectasia (IPT). Material and methods: Four eyes of three patients were included in this interventional case series. One patient (two eyes) had bilateral IPT (type 2) and two patients (two eyes) had unilateral (type 1) IPT. Retreatment was scheduled in case of leakage persistence in combination with visual acuity (VA) deterioration. Fluorescein angiography and optical coherence tomography were performed together with a full ophthalmic examination at baseline, 1, 3, 6, 9, and 12 months after injection. Results: One intravitreal injection of ranibizumab was performed in all four eyes. Complete cessation of leakage was documented postintervention in three eyes and partial cessation in one eye, followed by improvement of best corrected VA in one of them. In all eyes, structural changes of the photoreceptor layer were detected in tomography and were responsible for visual loss, which was in most cases, refractory to the applied therapy. Conclusion: Use of ranibizumab might be efficient in eliminating leakage activity in the macular region in patients with IPT. Nevertheless, improvement in VA was infrequent. Preexisting early photoreceptor alteration in IPT might render such patients unable to improve VA. Keywords: idiopathic parafoveal telangiectasis, intravitreal ranibizumab, fluorescein angiography, high-definition optical coherence tomography