Combined treatment for Coats' disease: retinal laser photocoagulation combined with intravitreal bevacizumab injection was effective in two cases.

[coats disease]

The exact pathogenetic mechanisms of Coats ' disease remain unknown . In this report , we show two cases of Coats ' disease that achieved a favorable prognosis with the combined treatment of intravitreal bevacizumab (IVB ) injection prior to photocoagulation , although both initially resisted photocoagulation therapy .Case 1 was a 15 -year -old boy with initial visual acuity of 0 .4 OD . At the temporal retina , aneurysms and abnormal telangiectatic vessels were observed . Hard exudates and an exudative retinal detachment extended to the fovea . He was diagnosed as having Coats ' disease at stage 3 A and we performed laser photocoagulation as an initial approach to treat peripheral aneurysms and telangiectatic vessels . After the treatment , the exudative retinal detachment was eased and visual acuity improved to 1 .0 ; however , recurrence occurred after 5 months . The exudative change was resistant against laser photocoagulation therapy and we therefore added IVB as an adjuvant before photocoagulation . Fourteen days after IVB injection phased laser photocoagulation was given to cover the abnormal capillaries , aneurysms and the leakage area spotted in FA . A good prognosis was obtained with decreased exudation and improved visual acuity .Case 2 was an 11 -year -old boy with decreased visual acuity of 0 .15 OS at the initial visit . Hard exudates , retinal edema and serous retinal detachment were seen at the macula and peripheral retina . Fluorescein angiography revealed telangiectatic capillaries at the temporal retina . Our diagnosis was Coats ' disease at stage 3 A . Extensive photocoagulation was performed as an initial treatment to the lesion . However , the exudative change was severe and resistant against the photocoagulation treatment . Therefore , we added IVB as an adjuvant before photocoagulation . Exudative change in the retina seemed to be eased 7 days after IVB injection , therefore , phased laser phototherapy was added to cover the abnormal capillaries . After the combination therapy , exudative change was remarkably ameliorated and better visual acuity was achieved .Bevacizumab is considered an effective adjuvant for Coats ' disease with exudative change resistant to retinal photocoagulation therapy .

Diseases
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Diseases presenting "peripheral aneurysms" symptom

coats disease

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