Bevacizumab/triamcinolone

Abstract

No therapeutic effect: case report A 54-year-old man exhibited no therapeutic effect during treatment with bevacizumab and triamcinolone for type 1 idiopathic macular telangiectasia (IMT) [dosages not stated]. The man presented with decreased central vision in the left eye for two years. His best-corrected visual acuity was 20/20 in the right eye and 20/800 in the left eye. He had received two intravitreal bevacizumab injections in his left eye at outside facility. Despite the treatment, detailed investigations demonstrated multiple dot haemorrhage, circinate hard exudates in the macula, extensive juxtafoveal capillary telangiectasia, aneurysms and severe cystoid macular oedema (CME). He was diagnosed with type 1 IMT. Therefore, he received one intravitreal triamcinolone injection, but no therapeutic effect achieved. Finally, the man was treated with three sessions of subthreshold micropulse yellow laser (SMYL) treatment around the juxtafoveal telangiectatic area. His left eye remained stable and best-corrected visual acuity improved to 20/40. However, in the large aneurysm region that was repeatedly treated with SYML, a progressive focal atrophic change occurred approximately one year after the third SMYL session. The atrophic change could have been the consequence of long-standing CME but could also had been triggered by repeated SMYL sessions.