Intravitreal Ranibizumab Treatment for Non-Proliferative Idiopathic Macular Telangiectasia

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Wichai Prasartritha
Somsiri Sukavatcharin
Boontip Tipsuriyaporn


Background: Idiopathic macular telangiectasia (IMT) associates with incompetence and ectasia of parafoveal retinal capillaries, causing significant loss of central vision. Many treatment modalities have been proposed to improve visual acuity such as laser, intravitreal injection of steroid, and anti-vascular endothelial growth factors. Nevertheless, the improvement in visual acuity was inconsistent.

Objective: To evaluate the effect of intravitreal ranibizumab on non-proliferative stage of idiopathic macular telangiectasia (IMT) in Thailand.

Methods: We conducted a retrospective, case series of 10 eyes (10 patients) in non-proliferative IMT treated with monthly intravitreal injection of 0.5 mg ranibizumab between July 2012 to March 2014 at Ramathibodi Hospital. Ophthalmic examination data, including best-corrected visual acuity (BCVA), fundus photograph, optical coherence tomography (OCT) and fluorescein angiogram (FA) were collected and interpreted by an experienced retinal specialist.

Results: Mean age was 52.9 ± 9.7 years. Median follow up time was 12.0 (8.0 - 17.0) months. Median BCVA improved from 0.35 (0.2 - 0.4) Logarithm of the Minimum Angle of Resolution (LogMAR) at baseline to 0.10 (0.0 - 0.3) LogMAR and 0.10 (0.0 - 0.4) LogMAR at third month and last visit, respectively. Mean central retinal thickness (CRT) was 374.3 ± 105.3 µm at baseline and decreased to 257.4 ± 84.3 µm and 242.4 ± 88.3 µm at third month and last visit, respectively. Mean changes in BCVA and CRT showed statistical significant different at third months and last visit compared to baseline. FA showed the reduction of leakage and staining at the end of treatment compared to baseline. No systemic and ocular adverse events were found.

Conclusions: Intravitreal ranibizumab might be the promising treatment for non-proliferative stage of IMT, in term of improving BCVA, decreasing CRT and FA leakage.


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How to Cite
Prasartritha, W., Sukavatcharin, S., & Tipsuriyaporn, B. (2017). Intravitreal Ranibizumab Treatment for Non-Proliferative Idiopathic Macular Telangiectasia. Ramathibodi Medical Journal, 40(3), 38-47. Retrieved from
Original Articles


1. Gass JD, Oyakawa RT. Idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol. 1982;100(5):769-780.

2. Gass JD, Blodi BA. Idiopathic juxtafoveolar retinal telangiectasis. Update of classification and follow-up study. Ophthalmology. 1993;100(10):1536-1546.

3. Yannuzzi LA, Bardal AM, Freund KB, Chen KJ, Eandi CM, Blodi B. Idiopathic macular telangiectasia. Arch Ophthalmol. 2006;124(4):450-460.

4. Park DW, Schatz H, McDonald HR, Johnson RN. Grid laser photocoagulation for macular edema in bilateral juxtafoveal telangiectasis. Ophthalmology. 1997;104(11):1838-1846.

5. Windisch R, Kozousek V. Intravitreal bevacizumab compared with photodynamic therapy with verteporfin for group 2a parafoveal retinal telangiectasis. Can J Ophthalmol. 2008;43(4):489-490. doi:10.3129/i08-069.

6. Cakir M, Kapran Z, Basar D, Utine CA, Eroglu F, Perente I. Optical coherence tomography evaluation of macular edema after intravitreal triamcinolone acetonide in patients with parafoveal telangiectasis. Eur J Ophthalmol. 2006;16(5):711-717.

7. Gamulescu MA, Walter A, Sachs H, Helbig H. Bevacizumab in the treatment of idiopathic macular telangiectasia. Graefes Arch Clin Exp Ophthalmol. 2008;246(8):1189-1193. doi:10.1007/s00417-008-0795-6.

8. Maia OO Jr1, Bonanomi MT, Takahashi WY, Nascimento VP, Takahashi BS. Intravitreal bevacizumab for foveal detachment in idiopathic perifoveal telangiectasia. Am J Ophthalmol. 2007;144(2):296-299.

9. Kovach JL, Rosenfeld PJ. Bevacizumab (avastin) therapy for idiopathic macular telangiectasia type II. Retina. 2009;29(1):27-32. doi:10.1097/IAE.0b013e31818ba9de.

10. Charbel Issa P, Finger RP, Holz FG, Scholl HP. Eighteen-month follow-up of intravitreal bevacizumab in type 2 idiopathic macular telangiectasia. Br J Ophthalmol. 2008;92(7):941-945. doi:10.1136/bjo.2007.129627.

11. Matsumoto Y, Yuzawa M. Intravitreal bevacizumab therapy for idiopathic macular telangiectasia. Jpn J Ophthalmol. 2010;54(4):320-324. doi:10.1007/s10384-010-0810-4.

12. Takayama K, Ooto S, Tamura H, et al. Intravitreal bevacizumab for type 1 idiopathic macular telangiectasia. Eye. 2010;24(9):1492-1497. doi:10.1038/eye.2010.61.

13. Charbel Issa P, Finger RP, Kruse K, Baumüller S, Scholl HP, Holz FG. Monthly ranibizumab for nonproliferative macular telangiectasia type 2: a 12-month prospective study. Am J Ophthalmol. 2011;151(5):876-886.e1. doi:10.1016/j.ajo.2010.11.019.

14. Toy BC, Koo E, Cukras C, Meyerle CB, Chew EY, Wong WT. Treatment of nonneovascular idiopathic macular telangiectasia type 2 with intravitreal ranibizumab: results of a phase II clinical trial. Retina. 2012;32(5):996-1006. doi:10.1097/IAE.0b013e31824690a8.

15. Ciarnella A, Verrilli S, Fenicia V, et al. Intravitreal ranibizumab and laser photocoagulation in the management of idiopathic juxtafoveolar retinal telangiectasia type 1: a case report. Case Rep Ophthalmol. 2012;3(3):298-303. doi:10.1159/000342848.

16. Rouvas A, Malamos P, Douvali M, Ntouraki A, Markomichelakis NN. Twelve months of follow-up after intravitreal injection of ranibizumab for the treatment of idiopathic parafoveal telangiectasia. Clin Ophthalmol. 2013;7:1357-1362. doi:10.2147/OPTH.S44109.

17. Do DV, Bressler SB, Cassard SD, et al. Ranibizumab for macular telangiectasia type 2 in the absence of subretinal neovascularization. Retina. 2014;34(10):2063-2071. doi:10.1097/IAE.0000000000000203.