In questo lavoro viene confermata la difficoltà nell’ottenere buoni risultati terapeutici in questa particolare forma di maculopatia su base vascolare. A distanza di 12 mesi, nonostante un misurabile effetto positivo sullo stato anatomico della retina, non si è riuscito ad ottenere un miglioramento visivo significativo in questa serie di pazienti trattati con Ranizumab (Lucentis) intravitreale.
Do, Diana V. MD*; Bressler, Susan B. MD†; Cassard, Sandra D. ScD‡; Gower, Emily W. PhD‡,§; Tabandeh, Homayoun MD¶; Jefferys, Joan L. MSc‡; Bressler, Neil M. MD†
May 2012 – Volume 32 – Issue 5 – p 996–1006
Methods: Single-center, open-label Phase II clinical trial enrolling five participants with bilateral nonneovascular idiopathic macular telangiectasia Type 2. Intravitreal ranibizumab (0.5 mg) was administered every 4 weeks in the study eye for 12 months with the contralateral eye observed. Outcome measures included changes in best-corrected visual acuity, area of late-phase leakage on fluorescein angiography, and retinal thickness on optical coherence tomography.
Results: The study treatment was well tolerated and associated with few adverse events. Change in best-corrected visual acuity at 12 months was not significantly different between treated study eyes (0.0 ± 7.5 letters) and control fellow eyes (+2.2 ± 1.9 letters). However, decreases in the area of late-phase fluorescein angiography leakage (−33 ± 20% for study eyes, +1 ± 8% for fellow eyes) and in optical coherence tomography central subfield retinal thickness (−11.7 ± 7.0% for study eyes and −2.9 ± 3.5% for fellow eyes) were greater in study eyes compared with fellow eyes.
Conclusion: Despite significant anatomical responses to treatment, functional improvement in visual acuity was not detected. Intravitreal ranibizumab administered monthly over a time course of 12 months is unlikely to provide a general and significant benefit to patients with nonneovascular idiopathic macular telangiectasia Type 2.