Long-Term Outcomes in Macular Telangiectasia Type 2 With Subretinal Neovascularization

Area of Science:

• Ophthalmology
• Retinal Diseases
• Neovascularization

Background:

• Macular telangiectasia type 2 (MacTel) is a degenerative retinal disease.
• Subretinal neovascularization (SRNV) can be a complication of MacTel, potentially impacting vision.
• Long-term outcomes of MacTel with SRNV treated with anti-VEGF therapy require further investigation.

Purpose of the Study:

• To report long-term outcomes in patients with MacTel and secondary SRNV.
• To evaluate the efficacy of anti-VEGF therapy in this patient cohort.
• To compare outcomes based on the timing of SRNV development.

Main Methods:

• Retrospective review of 471 MacTel patient records from May 2004 to October 2019.
• Analysis of 38 eyes with SRNV secondary to MacTel, focusing on best-corrected visual acuity (BCVA) and treatment history.
• Subgroup analysis based on SRNV presentation at diagnosis versus development during follow-up.

Main Results:

• Overall BCVA in the SRNV group showed no significant change from baseline to final follow-up (P=.13).
• Eyes with SRNV at diagnosis treated immediately showed stable BCVA (0.89 to 0.87, P=.84).
• Eyes developing SRNV during follow-up showed improved BCVA after treatment initiation (P=.04) but a decrease from pre-SRNV baseline (P=.008).

Conclusions:

• Anti-VEGF therapy maintains visual acuity in MacTel with SRNV but does not lead to significant improvement in the long term.
• Patients presenting with SRNV at the time of MacTel diagnosis have a worse visual prognosis.
• The timing of SRNV onset influences the long-term visual outcome in MacTel patients.