Intravitreal injection of ranibizumab and combined treatment for severe Coats disease_Chinese Journal of Ocular Fundus Diseases

Authors：

YangQiong ,  WeiWenbin , LiuYueming , 杨丽红

Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China;

Corresponding author：

WeiWenbin, Email: tr-weiwenbin@163.com

Keywords：

Retinal telangiectasis/therapy; Angiogenesis inhibitors/therapeutic use; Antibodies,monoclonal/therapeutic use

DOI：

10.3760/cma.j.issn.1005-1015.2014.05.008

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Objective To observe the efficacy of intravitreal injection of ranibizumab (IVR) and combined treatment for severe Coats disease. Methods Nineteen Coats disease patients (24 eyes) were enrolled in this retrospective non-comparative interventional clinical study. The patients included 17 males and 2 females. The age was ranged from 1 to 42 years old, with an average of (13.05±6.78) years. The patients included 15 children (age ≤14 years old) and 4 adults (age ≥18 years old). There were 13 patients with 3a stage and 6 patients with 3b stage. The treatment methods including IVR only, IVR combined with cryotherapy, IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, IVR combined with vitrectomy. Treatments were repeated if it was necessary at the first day, the first week and the first month after injection. The interval between treatments was ≥1 month. Eleven patients (57.9%) underwent one treatment, 3 patients (15.8%) underwent 2 treatments, 3 patients (15.8%) underwent 3 treatments, 2 patients (10.5%) underwent 4 treatments. The treatment frequency including 22 times of IVR only, 6 times of IVR combined with cryotherapy, 5 times of IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, 1 time of IVR combined with vitrectomy. The follow-up period was ranged from 6 to 36 months, with an average of (19.11±7.05) months. Visual acuity, retinal reattachment and ocular adverse events were observed. Results Three children (15.8%) were failing to test the visual acuity. Visual acuity was improved in 2 patients (10.5%), stable in 13 patients (68.4%) and decreased in 1 patient (5.3%). Three patients (15.8%) achieved totally retinal reattachment after treatment, while 16 patients (84.2%) achieved partially retinal reattachment. One patient had vitreous hemorrhage. One patient had neovascular glaucoma. Conclusion IVR and combined treatment were effective for severe Coats disease.

Citation： YangQiong, WeiWenbin, LiuYueming. Intravitreal injection of ranibizumab and combined treatment for severe Coats disease. Chinese Journal of Ocular Fundus Diseases, 2014, 30(5): 462-465. doi: 10.3760/cma.j.issn.1005-1015.2014.05.008 Copy

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11.	Smithen LM, Brown GC, Brucker AJ, et al. Coats' disease diagnosed in adulthood[J]. Ophthalmology, 2005,112:1072-1078.

1. Zhang H, Liu ZL.Increased nitric oxide and vascular endothelial growth factor levels in the aqueous humor of patients with Coats disease[J]. J Ocul Pharmacol Ther, 2012, 28:397-401.
2. He YG, Wang H, Zhao B,et al.Elevated vascular endothelial growth factor level in Coats disease and possible therapeutic role of bevacizumab[J]. Graefe's Arch Clin Exp Ophthalmol, 2010, 248:1519-1521.
3. Sun Y, Jain A, Moshfeghi DM. Elevated vascular endothelial growth factor levels in Coats disease response to pegaptanib sodium[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245:1387-1388.
4. Sigler EJ, Randolph JC, Calzada JI, et al.Current management of Coats disease[J]. Surv Ophthalmol, 2014, 59:30-46.
5. Kaul S, Uparkar M, Mody K, et al. Intravitreal anti-vascular endothelial growth factor agents as an adjunct in the management of Coats disease[J]. Indian J Ophthalmol, 2010, 58:76-78.
6. Lin CJ, Hwang JF, Chen YT, et al.The effect of intravitreal bevacizumab in the treatment of Coats disease in children[J]. Retina, 2010, 30:617-622.
7. Shields JA, Shields CL, Honavar SG, et al. Clinical variations and complications of Coats disease in 150 cases:the 2000 Sanford Gifford Memorial Lecture[J]. Am J Ophthalmol, 2001, 131:561-571.
8. Shields JA, Shields CL, Honavar SG, et al.Classification and management of Coats disease:the 2000 Proctor Lecture[J].Am J Ophthalmol, 2001, 131:572-583.
9. Bergstrom CS, Hubbard GB 3rd. Combination intravitreal triamcinolone injection and cryotherapy for exudative retinal detachments in severe Coats disease[J]. Retina, 2008, 28:33-37.
10. Otani T, Yasuda K, Aizawa N, et al. Over 10 years follow-up of Coats' disease in adulthood[J]. Clin Ophthalmol, 2011, 5:1729-1732.
11. Smithen LM, Brown GC, Brucker AJ, et al. Coats' disease diagnosed in adulthood[J]. Ophthalmology, 2005,112:1072-1078.

Chinese Journal of Ocular Fundus Diseases

Intravitreal injection of ranibizumab and combined treatment for severe Coats disease

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