Anti-VEGF agents treatment outcomes in macular telangiectasia
Reviewed by Sofia Rokerya

This article is a review of a systematic literature search on Ovid MEDLINE, Embase, and Cochrane Library, from inception to June 2024 for comparative studies on anti-VEGF agents in macular telangiectasia (MacTel). The primary outcome was the change in best-corrected visual acuity (BCVA) and secondary outcomes were central macular thickness (CMT), central choroidal thickness (CCT), and fluorescein angiography (FA) leakage. Ten studies on 377 eyes of 239 patients followed up over 23.4 ±8.3 months were included. In non-proliferative MacTel, mean (SD) BCVA changed from 0.42 (0.39) to 0.35 (0.18) over 23.4 (8.3) months of follow-up. Four studies showed no functional improvement, two reported significant functional and morphological improvements, and one suggested potential benefits in improving BCVA. Mean CMT changed from 201 (32) µm to 199 (29) µm. In proliferative MacTel with choroidal neovascularisation (CNV), mean BCVA changed from 0.66 (0.43) to 0.52 (0.34) at final follow-up. Five studies reported improved visual acuity, one showed improved FA leakage without visual acuity benefit, and four found no functional benefit. Two studies demonstrated improvement in both anatomical and functional outcomes, while one indicated that anti-VEGF treatment might produce improved results. CMT in patients with CNV decreased from an initial value of 328.23 (161.16) µm to 267.44 (118.56) µm at the final follow-up. CCT in proliferative MacTel eyes decreased from 272.37 (52.65) µm and 247.40 (48.80) µm on anti-VEGF therapy. The study concluded that there is a lack of literature on visual acuity outcomes in the setting of MacTel. Anti-VEGF agents may be associated with favourable anatomical and functional outcomes, particularly in proliferative MacTel. There were similar positive outcomes with minimal adverse events in both clinical cohorts, irrespective of the agent, however, the limited evidence suggests the need for future large-scale randomised control trials (RCTs).

Anti-vascular endothelial growth factor treatment outcomes in macular telangiectasia: a systematic review.
Sriranganathana A, Grad J, Mihalachec A, et al.
OPHTHALMOLOGICA
2025;248:123–36.