intensity in a grid-pattern and on multiple occasions, if necessary, are recommended. It is unnecessary to destroy every dilated capillary, and, particularly during the initial session of photocoagulation, those on the edge of the capillary-free zone should be avoided. Intravitreal injections of triamcinolone acetonide (IVTA) which have proved to be beneficial in the treatment of macular edema by their anti-inflammatory effect, their downregulation of VEGF production, and stabilization of the blood retinal barrier, were reported anecdotally in the management of Macular telangiectasia type 1. In two case reports, IVTA of 4 mg allowed a transitory reduction of retinal edema, with variable or no increase in visual acuity (VA). As expected with all IVTA injections, the edema recurred within 3–6 months, and no permanent improvement could be shown. In general, the effect of IVTA is short-lived and complications, mainly increased intraocular pressure and cataract, limit its use. Indocyanine green angiography-guided laser photocoagulation directed at the leaky microaneurysms and vessels combined with sub-Tenon’s capsule injection of triamcinolone acetonide has also been reported in a limited number of patients with Macular telangiectasia type 1 with improvement or stabilization of vision after a mean follow-up of 10 months. Further studies are needed to assess the efficacy of this treatment modality. Recently, intravitreal injections of anti-VEGF agents, namely bevacizumab, a humanized monoclonal antibody targeted against pro-angiogenic, circulatory VEGF; and ranibizumab, a FDA-approved monoclonal antibody fragment that targets all VEGF-A isoforms, have shown improved visual outcome and reduced leakage in macular edema from diabetes and retinal venous occlusions. In one reported patient with Macular telangiectasia type 1, a single intravitreal bevacizumab injection resulted in a marked increase in VA from 20/50 to 20/20, with significant and sustained decrease in both leakage on fluorescein angiography (FA) and cystoid macular edema on optical coherence tomography (OCT) up to 12 months. It is likely that patients with Macular telangiectasia type 1 with pronounced macular edema from leaky telangiectasis may benefit functionally and morphologically from intravitreal anti-VEGF injections, but this warrants further studies. Today, laser photocoagulation remains mostly effective, but the optimal treatment of Macular telangiectasia type 1 is questioned, and larger series comparing different treatment modalities seem warranted. The rarity of the disease, however, makes it difficult to assess in a controlled randomized manner. A 2014 case study of a single type 1 macular telangiectasia patient concluded Bevacizumab was not effective, but Aflibercept produced beneficial results. Type 2 (MacTel)