Tingyi Liang1, Jie Peng1, Qi Zhang1, Xiuyu Zhu1, Yu Xu1, Peiquan Zhao2. 1. Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. zhaopeiquan@xinhuamed.com.cn.
Abstract
PURPOSE: To present a combined treatment modality in the management of stage 3B Coats disease and to evaluate its efficacy in the long-term follow-up. METHODS: This study was a retrospective review of 29 eyes from 29 consecutive patients who had stage 3B Coats disease with total exudative retinal detachment (ERD). The combined treatment modality consisted of external drainage of subretinal fluid (SRF), followed by endolaser photocoagulation via a nonvitrectomy approach, and intravitreal ranibizumab injection. Final disease status, anatomic success, and final visual acuity were the main outcome measures. RESULTS: The treated eyes initially received one session of external drainage of SRF, followed by an average of 1.4 sessions (range, 1 to 3 sessions) of endolaser photocoagulation and intravitreal ranibizumab injection. With a median follow-up period of 40 months (range, 21-81 months), all eyes demonstrated no disease progression, including 6 eyes that required vitrectomy with silicone oil tamponade due to increasing ERD after initial treatment. No enucleation was required. At the final follow-up, anatomic success with retinal reattachment and no active disease was achieved in 24 of 29 eyes (82.8%). Fibrosis was observed in 22 eyes (75.9%) with a mean onset time of 9 months (range, 5-16 months); of these, 3 and 9 eyes developed tractional retinal detachment and epiretinal membrane, respectively. In 62.1% of the eyes, the final visual acuity was only light perception or no light perception. CONCLUSION: The combined treatment modality presented in this study is an effective way in the management of stage 3B Coats disease with total ERD.
PURPOSE: To present a combined treatment modality in the management of stage 3B Coats disease and to evaluate its efficacy in the long-term follow-up. METHODS: This study was a retrospective review of 29 eyes from 29 consecutive patients who had stage 3B Coats disease with total exudative retinal detachment (ERD). The combined treatment modality consisted of external drainage of subretinal fluid (SRF), followed by endolaser photocoagulation via a nonvitrectomy approach, and intravitreal ranibizumab injection. Final disease status, anatomic success, and final visual acuity were the main outcome measures. RESULTS: The treated eyes initially received one session of external drainage of SRF, followed by an average of 1.4 sessions (range, 1 to 3 sessions) of endolaser photocoagulation and intravitreal ranibizumab injection. With a median follow-up period of 40 months (range, 21-81 months), all eyes demonstrated no disease progression, including 6 eyes that required vitrectomy with silicone oil tamponade due to increasing ERD after initial treatment. No enucleation was required. At the final follow-up, anatomic success with retinal reattachment and no active disease was achieved in 24 of 29 eyes (82.8%). Fibrosis was observed in 22 eyes (75.9%) with a mean onset time of 9 months (range, 5-16 months); of these, 3 and 9 eyes developed tractional retinal detachment and epiretinal membrane, respectively. In 62.1% of the eyes, the final visual acuity was only light perception or no light perception. CONCLUSION: The combined treatment modality presented in this study is an effective way in the management of stage 3B Coats disease with total ERD.
Authors: Andrea Grosso; Marco Pellegrini; Matteo G Cereda; Claudio Panico; Giovanni Staurenghi; Eric J Sigler Journal: Retina Date: 2015-04 Impact factor: 4.256