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Advanced Coats' disease treated with intravitreal bevacizumab combined with laser vascular ablation.
[coats disease]
To
evaluate
the
impact
of
intravitreal
bevacizumab
combined
with
laser
vascular
ablation
in
the
management
of
advanced
Coats
'
disease
presenting
with
exudative
retinal
detachment
.
This
was
a
retrospective
review
of
24
children
that
presented
with
exudative
retinal
detachments
associated
with
advanced
Coats
'
disease
.
Mean
patient
age
was
62
months
(
range
9
-
160
months
)
.
Presenting
signs
included
retinal
detachment
in
24
children
(
100
%
)
,
vascular
telangiectasia
in
24
children
(
100
%
)
,
and
retinal
ischemia
in
24
children
(
100
%
)
.
Twenty
of
24
children
presented
with
elevated
,
vascular
leakage
in
the
fovea
(
83
%
)
.
Two
children
presented
with
sub-
retinal
fibrosis
associated
with
presumed
long
-standing
retinal
detachment
without
evidence
of
rhegmatogenous
retinal
detachment
.
Ten
patients
exhibited
vascular
alterations
in
the
periphery
of
the
second
eye
without
clinical
evidence
of
exudation
.
All
24
children
were
treated
with
a
large
-spot-size
diode
laser
directly
to
areas
of
abnormal
telangiectatic
vasculature
.
All
24
children
received
intravitreal
bevacizumab
injection
.
All
24
children
had
resolution
of
exudative
retinal
detachment
,
ablation
of
vascular
telangiectasia
,
and
anatomic
improvement
of
the
retina
.
No
child
exhibited
progressive
retinal
detachment
and
no
eye
required
enucleation
.
No
cases
of
neovascular
glaucoma
were
seen
.
Fellow
eyes
with
peripheral
vascular
alterations
showed
no
progression
to
exudative
vasculopathy
during
the
observation
period
.
Intravitreal
bevacizumab
injection
was
not
associated
with
endophthalmitis
or
systemically-
observed
complications
.
Repetitive
intravitreal
bevacizumab
combined
with
laser
vascular
ablation
may
be
utilized
effectively
for
advanced
Coats
'
disease
presenting
with
exudative
retinal
detachment
.
Diseases
Validation
Diseases presenting
"no eye required enucleation"
symptom
coats disease
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