Triple Therapy Management of Macular Telangiectasia

Abstract

We report the case of a 65 year old lady presen ng with sudden diminu on of vision in her right eye (RE) with the best corrected visual acuity (BCVA) being coun ng fi ngers at 1 metre. Complete ocular examina on and op cal coherence tomography (OCT) revealed a sub-macular hemorrhage (SMH) in her RE. She was treated with a triple therapy consis ng of intra vitreal ssue plasminogen ac vator (tPA), bevacizumab and sulphur hexafl uoride (SF6) gas tamponade. At one month into follow up, her SMH had resolved. At this point fl uorescein angiography and OCT revealed a subre nal neovascular membrane in the RE and decreased foveal thickness in both eyes. This led to the diagnosis of Stage 5 macular telangiectasis in the right eye and Stage 1 macular telangiectasis in the le eye (LE). She received another intra vitreal injec on of bevacizumab. At 3 months follow up her BCVA is 20/40, N6 in the right eye signifying the effi cacy of prompt use of triple therapy in cases of sub-macular hemorrhage where an underlying neovascular membrane is suspected as a cause.