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RANIBIZUMAB IN THE MANAGEMENT OF ADVANCED COATS DISEASE STAGES 3B AND 4: Long-term Outcomes.
[coats disease]
Laser
photocoagulation
and
cryotherapy
to
completely
destroy
telangiectatic
vessels
and
ischemic
retina
in
Coats
disease
is
barely
applicable
in
advanced
cases
with
total
retinal
detachment
,
and
globe
survival
is
notoriously
poor
in
Stages
3
B
and
4
.
Anti-
vascular
endothelial
growth
factor
intravitreal
injections
may
offer
new
prospects
for
these
patients
.
This
study
is
a
retrospective
review
of
all
consecutive
patients
with
Coats
disease
treated
with
neoadjuvant
or
adjuvant
intravitreal
ranibizumab
plus
conventional
and
amblyopia
treatment
as
appropriate
.
Nine
patients
(
median
age
,
13
months
)
presenting
Coats
Stages
3
B
and
4
(
5
and
4
eyes
,
respectively
)
were
included
.
Iris
neovascularization
resolved
within
2
weeks
and
retinal
reapplication
within
4
months
in
all
patients
.
At
last
follow-up
,
globe
survival
was
100
%
with
anatomical
success
in
8
of
the
9
eyes
.
With
a
median
follow-up
of
50
months
,
fibrotic
vitreoretinopathy
was
developed
in
5
of
the
9
cases
,
one
leading
to
tractional
retinal
detachment
and
ultimately
phthisis
bulbi
.
The
remaining
4
of
the
9
eyes
achieved
some
vision
(
range
,
0
.
02
-
0
.
063
)
.
To
the
best
of
the
authors
'
knowledge
,
this
is
the
largest
reported
series
of
late
-
stage
Coats
undergoing
anti-
vascular
endothelial
growth
factor
therapy
,
a
homogenous
cohort
of
patients
treated
with
a
single
agent
and
with
the
longest
follow-up
.
This
study
supports
the
role
of
ranibizumab
in
advanced
disease
by
transient
restoration
of
the
hemato-
retinal
barrier
and
suppression
of
neovascularization
to
facilitate
classic
treatment
.
At
the
last
follow-up
,
the
authors
report
unprecedented
anatomical
success
and
functional
outcome
.
Diseases
Validation
Diseases presenting
"and globe survival is notoriously poor in stages 3b and 4"
symptom
coats disease
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