Current Treatments in Primary Retinal Talengiectasias

Dr. Fatma Sema Akkan Aydoğmuş, FEBO

Ankara Bilkent City Hospital, Department of Ophthalmology, Ankara, Türkiye

ABSTRACT

Primary retinal telangiectasias include a group of rare, idiopathic, congenital or acquired retinal vascular anomalies characterized by dilatation and tortuosity of retinal blood vessels, multiple aneurysms, vascular leakage, and accumulation of hard exudates. Primary retinal telangiectasias are Macular Telangiectasia Type 1: aneurysmal telangiectasia (MacTel 1), Macular Telangiectasia Type 2: perifoveal telangiectasia (MacTel 2) and Coats disease. MacTel 1 is usually seen unilaterally in young men, and its standard treatment is laser pho- tocoagulation of leakage points and areas. Laser photocoagulation remains the standard of care for macular edema secondary to MacTel type 1. MacTel 2 is a bilateral asymmetric form more common in middle-aged to older people. If secondary neovascularization develops, intravitreal anti-vascular endothelial growth factor (anti-VEGF) is required. Coats disease is characterized by aneurysmal retinal vessels with intraretinal and subretinal exudation. Although it is common in young men, it can also be seen in middle-aged older women. Treatment for Coats disease depends on the stage of the disease. Laser photocoagulation and cryotherapy in the early stages and surgical treatments with subretinal fluid drainage in the advanced stages are standard treatment regimens. Nowadays, anti-VEGF therapy and laser combinations have begun to be used, especially in the adult population.

Keywords: Coats disease; Laser photocoagulation; Macular telangiectasia; MacTel; Retinal telangiectasia

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