Secondary Coats' response to retinal vasculitis managed with bevacizumab

Indian J Ophthalmol. 2018 Sep;66(9):1355-1357. doi: 10.4103/ijo.IJO_279_18.

Abstract

We report a case of 22-year-old young male who presented with a 3-month history of gradual and painless decrease of vision in his right eye (RE). On ophthalmological examination, best-corrected visual acuity in his RE was counting finger close to the face. Left eye ophthalmic examination was unremarkable. RE indirect ophthalmoscopy revealed multiple telangiectatic vessels, aneurysmal dilations, extensive yellow (lipid) exudation over the posterior pole along with perivascular exudation, and multiple sclerosed vessels in peripheral retina. Fluorescein angiography also revealed progressive leakage from telangiectasias, multiple aneurysmal outpouchings, extensive capillary dropouts, and vascular communicating channels in all quadrants. Spectral-domain-optical coherence tomography of macula demonstrated marked intraretinal fluid. Based on the above findings, a diagnosis of healed retinal vasculitis with Coats'-like response was made. The patient received 4-weekly two intravitreal bevacizumab injections which resulted in stabilization of the retinal findings and improvement in visual acuity.

Keywords: Bevacizumab; Coats'-like response; fundus fluorescein angiography; optical coherence tomography; retinal vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Bevacizumab / administration & dosage*
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Macula Lutea / pathology
  • Male
  • Ophthalmoscopy
  • Retinal Telangiectasis / diagnosis
  • Retinal Telangiectasis / drug therapy
  • Retinal Telangiectasis / etiology*
  • Retinal Vasculitis / complications*
  • Retinal Vasculitis / diagnosis
  • Retinal Vasculitis / drug therapy
  • Tomography, Optical Coherence
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab