Treatment of Advanced Coats' Disease With Combination Therapy of Laser Photocoagulation, Intravitreal Ranibizumab, and Sub-Tenon Methylprednisolone Acetate

J Pediatr Ophthalmol Strabismus. 2022 May-Jun;59(3):187-191. doi: 10.3928/01913913-20211110-02. Epub 2021 Dec 20.

Abstract

Purpose: To investigate the efficacy of combination therapy with laser photocoagulation, intravitreal ranibizumab, and sub-Tenon methylprednisolone acetate in patients presenting with advanced Coats' disease.

Methods: This was a retrospective analysis of 16 patients who underwent laser photocoagulation combined with intravitreal ranibizumab and sub-Tenon methylprednisolone acetate between 2008 and 2017. The primary outcome was anatomic success and the secondary outcomes were globe preservation and final visual acuity.

Results: The average age at surgery was 5.12 ± 2.7 years (range: 3 to 10 years). The mean follow-up time was 45.43 ± 29.01 months (range: 12 to 108 months). Of the 16 patients (16 eyes) reviewed, 6 patients had stage 3A and 10 patients had stage 3B Coats' disease. The mean number of applications was 10 (range: 4 to 18). Globe preservation was achieved in all patients. Final visual acuity outcomes were satisfactory: 20/20 to 20/50 in 2 patients, 20/60 to 20/100 in 1 patient, and 20/200 or worse in 13 patients.

Conclusions: Intravitreal ranibizumab used in combination with laser photocoagulation and sub-Tenon methylprednisolone acetate could be an effective treatment option for patients with advanced Coats' disease. The combined therapy achieved anatomical success, globe preservation, and reasonable visual acuity outcomes. [J Pediatr Ophthalmol Strabismus. 2022;59(3):187-191.].

MeSH terms

  • Acetates / therapeutic use
  • Angiogenesis Inhibitors / therapeutic use
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Laser Coagulation
  • Lasers
  • Methylprednisolone Acetate / therapeutic use
  • Ranibizumab / therapeutic use
  • Retinal Telangiectasis* / diagnosis
  • Retinal Telangiectasis* / therapy
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A

Substances

  • Acetates
  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Methylprednisolone Acetate
  • Ranibizumab