[Idiopathic macular telangiectasia: clinical appearance, imaging and treatment]

This work aims to summarize the clinical features of idiopathic macular telangiectasia (IMT) and the role of imaging in this condition as well as to review available treatments.

This is a retrospective analysis of IMT patients diagnosed, followed and treated between June 2010 and March 2012 at the Red Cross Hospital in Lyon. Patients were identified on the basis of Yanuzzi classification. Funduscopic appearance, fluorescein angiography, autofluorescence photos and high-resolution spectral domain ocular coherence tomography (SD-OCT) allowed these IMT patients to be classified into two groups. Patients with visual loss secondary to cystoid macular edema were treated with laser and/or intravitreal anti-VEGF injection.

Four patients were examined on the basis of decreased visual acuity secondary to IMT. The combination of fluorescein angiography and SD-OCT allowed the diagnosis of two patients as group 1 IMT and two patients as group 2 IMT. Patients with group 1 telangiectasias were treated by laser and/or intravitreal anti-VEGF. We found functional and anatomical efficacy of anti-VEGF treatment for group 1 IMT.

The physiopathology of IMT is complex and still remains imperfectly understood. Anti-VEGF treatment appears to be an effective alternative for the treatment of cystoid macular edema in group 1 IMT.

The physiopathology of IMT is very complex. We have shown that anti-VEGF seems to give satisfactory results for cystoid macular edema in group 1 IMT, although several reinjections may be required. It seems that there is no effective treatment for group 2 IMT without neovascular complications. Future therapeutic progress in the treatment of atrophic age-related macular degeneration will probably be effective in this condition as well.