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Bevacizumab for Coats' disease with exudative retinal detachment and risk of vitreoretinal traction.
[coats disease]
To
evaluate
the
effect
of
supplemental
intravitreal
bevacizumab
for
management
of
Coats
'
disease
.
Retrospective
analysis
of
eight
patients
with
Coats
'
disease
manifesting
total
or
partial
exudative
retinal
detachment
where
the
retinal
telangiectasia
was
treated
with
standard
laser
photocoagulation
and
/
or
cryotherapy
plus
additional
intravitreal
bevacizumab
(
1
.
25
mg
/
0
.
05
ml
)
.
The
mean
patient
age
was
88
(
range
7
-
240
)
months
and
63
%
were
male
.
Coats
'
disease
was
classified
as
stage
2
(
n
=
1
,
12
%
)
,
3
a
(
n
=
3
,
38
%
)
and
3
b
(
n
=
4
,
50
%
)
.
Features
included
retinal
detachment
(
n
=
8
,
100
%
with
mean
detachment
extent
involving
8
clock
hours
)
,
telangiectasia
(
n
=
8
,
100
%
with
mean
extent
of
8
clock
hours
)
,
peripheral
retinal
ischaemia
on
fluorescein
angiography
(
n
=
7
,
88
%
)
and
no
evidence
of
neovascularisation
.
Treatment
consisted
of
cryotherapy
(
n
=
8
,
100
%
)
,
laser
photocoagulation
(
n
=
4
,
50
%
)
and
bevacizumab
intravitreal
injection
(
n
=
8
)
with
median
number
of
one
injection
per
eye
(
mean
1
.
75
,
and
range
1
-
4
injections
)
.
After
a
mean
follow-up
of
8
.
5
months
,
resolution
of
retinopathy
(
n
=
8
,
100
%
)
,
Coats
'
-
related
subretinal
fluid
(
n
=
8
,
100
%
)
and
retinal
exudation
(
n
=
6
,
75
%
)
was
noted
.
However
,
vitreous
fibrosis
developed
(
n
=
4
,
50
%
)
at
a
mean
of
5
months
following
a
mean
of
1
.
75
bevacizumab
injections
with
three
(
38
%
)
evolving
into
traction
retinal
detachment
.
Coats
'
disease
treated
with
intravitreal
bevacizumab
in
addition
to
standard
therapy
can
develop
to
vitreoretinal
fibrosis
and
potentially
traction
retinal
detachment
.
These
tractional
features
are
not
often
found
in
Coats
'
disease
treated
with
standard
measures
without
bevacizumab
.
Caution
is
advised
in
the
use
of
bevacizumab
for
patients
with
Coats
'
disease
.
Diseases
Validation
Diseases presenting
"telangiectasia"
symptom
coats disease
cowden syndrome
cutaneous mastocytosis
hereditary cerebral hemorrhage with amyloidosis
kallmann syndrome
kindler syndrome
malignant atrophic papulosis
omenn syndrome
pendred syndrome
severe combined immunodeficiency
systemic capillary leak syndrome
triple a syndrome
waldenström macroglobulinemia
werner syndrome
This symptom has already been validated
