Intravitreal Faricimab for the Management of Bilateral Macular Neovascularization Secondary to Macular Telangiectasia Type 2

Macular telangiectasia type 2 (MacTel2) is a bilateral neurodegenerative disease characterized by telangiectasia of macular vasculature and foveal atrophy that is typically acquired during middle age. It may lead to visual loss due to progressive reduction of photoreceptor function or secondary to macular neovascularization. We report a case of bilateral macular neovascularization associated with MacTel2, which was treated with intravitreal faricimab injections. A 52-year-old female presented with a history of progressive reduction of vision in both eyes. Dilated fundus examination revealed the presence of perifoveal telangiectasia and right-angled venules in the juxtafoveal region. Diagnosis of MacTel2 and associated macular neovascularization (MNV) was confirmed with fundus fluorescein angiography (FA), optical coherence tomography (OCT), and angiography (OCTA). The patient was treated with three bilateral injections of faricimab on a monthly basis. Following the last injection, there was improvement of best corrected visual acuity (BCVA), reduction of macular thickening on OCT, and shrinkage of the MNV on OCTA. This is the first reported case of usage of intravitreal injection of faricimab for the management of visual loss due to macular neovascularization due to MacTel2.