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Optical coherence tomography and optical coherence tomography angiography helped identify this condition as bilateral MacTel II with outer retinal neovascularisation and subretinal neovascularisation. Over 1 year of follow-up, progressive vision loss and neovascular changes were noted in the left eye compared with the stable vision and minimal neovascular changes in the right eye. We explore the possible role of pigment proliferation in preventing the progression of neovascularisation in eyes with MacTel II.<\/jats:p>","DOI":"10.1136\/bcr-2025-267023","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:35:18Z","timestamp":1756902918000},"page":"e267023","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A possible protective role of pigment proliferation against subretinal neovascularisation progression in idiopathic macular telangiectasia type II"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2125-4329","authenticated-orcid":false,"given":"Sagar","family":"Agarwal","sequence":"first","affiliation":[{"name":"Ophthalmology, Janki Eye Clinic, Khatima, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2622-2397","authenticated-orcid":false,"given":"Madhurima 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