Treatment of nonproliferative type 2 idiopathic macular telangiectasia (IMT), a neurodegenerative disease that primarily affects the central retina, has remained a challenge up until this point. Looking to bridge this gap, researchers recently found that off-label Age-Related Eye Disease Study 2 (AREDS2) supplementation may prevent anatomical and visual deterioration in a subset of nonproliferative type 2 IMT eyes.
This retrospective, comparative, single-center study evaluated 82 type 2 IMT eyes treated with AREDS2 supplements. The study analysis consisted of a non-comparative arm, which included all AREDS2 eyes, and a comparative arm of 27 AREDS2 and 42 untreated eyes. Eyes were evaluated at baseline and again at 12 and 24 months.
In the non-comparative arm, AREDS2 eyes showed stable best-corrected visual acuity (0.28logMAR at baseline vs. 0.26logMAR at 24 months) and OCT anatomical features after 24 months of supplementation. On the other hand, in the comparative arm BCVA mean difference was greater for untreated eyes at 24 months (-0.09logMAR vs. 0.03logMAR). Untreated eyes had worse BCVA at 24 months in both better and worse eyes.
AREDS2 eyes had decreased cavitary diameter and ellipsoid zone loss compared with untreated eyes at the study endpoint. Increases in both cavitary diameter and ellipsoid zone loss among untreated eyes were only significant for eyes with worse baseline BCVA. Central macular thickness remained stable for both cohorts throughout the study.
“Off-label AREDS2 supplementation in nonproliferative type 2 IMT is associated with stabilization of structural deterioration and visual decline,” the study authors concluded in their paper. “Given the minimal risk of severe adverse events, noninvasive delivery and low cost of AREDS2, further exploration with a prospective, randomized clinical trial is warranted.”
Berger TA, Manry MW, Lindsell LB, et al. Outcome of off-label AREDS 2 supplementation for the treatment of macular degeneration in non-proliferative idiopathic type 2 macular telangiectasia. Clin Ophthalmol. 2021;15:1133-43.