Abstract
RATIONALE: Idiopathic macular telangiectasia type 1 (MacTel 1) almost always occurs unilaterally, bilateral MacTel 1 in female is unusual and has only been described rarely in literature. This study reviews the literature on clinical and imaging presentations of bilateral MacTel 1 and treatment options. This report aims to raise awareness among clinicians regarding such rare clinical scenarios. PATIENT CONCERNS: A 76-year-old female patient presented with blurred vision in both eyes for over 5 years. She had a history of well-controlled hypertension for more than 6 years, her best-corrected visual acuity was 0.06 in the right eye and 0.25 in the left eye. DIAGNOSES: Fundus examination, ultra-widefield fluorescein angiography and optical coherence tomography/optical coherence tomography angiography images supported the diagnosis of bilateral MacTel 1. INTERVENTIONS: She received intravitreal anti-vascular endothelial growth factor therapy in oculus uterque, and the left eye was treated with a dexamethasone intravitreal implant. OUTCOMES: The patient's condition was characterized by cystoid macular edema and hard exudate, without response to anti-vascular endothelial growth factor drug. However, a dexamethasone implant showed improvement of the cystoid macular edema, but her best-corrected visual acuity remained unchanged. LESSONS: This case of bilateral MacTel 1 in a female provides valuable insights into multimodal imaging studies and interventions for this uncommon condition.