A Review of Intravitreal Treatment Alternatives Used as an Adjunctive Therapy in Coats' Disease

Abstract

AIM:To review the intravitreal treatment alternatives used as an adjunctive therapy in Coats' disease. CONTEXT: The goal of therapy in Coats' disease is essentially to obliterate all retinal nonperfused areas and ablate retinal vascular abnormalities in order to provide subretinal fluid resolution and regression of hard exudates whenever feasible. However, both antiVEGFs and steroids are also administered intravitreally to improve the anatomic and functional outcome in cases with Coats' disease by many clinicians nowadays. METHODS: A comprehensive literature search in the databases of Pubmed and Cochrane Library was conducted in July 2015 to obtain all manuscripts related to Coats' disease and intravitreal treatment. Results: Among 71 search results, 34 relevant studies, predominately in the form of case reports and small case series were included. These were evaluated in detail and summarized in this report. CONCLUSIONS: There is a growing body of literature on the use of intravitreal agents as an adjunctive treatment for Coats' disease. However there is still open questions, particularly regarding the drug choice and long-term safety. Coming years will ascertain the place of intravitreal pharmacotherapy, which may find a niche in the treatment armamentarium of Coats' disease.

Exudative Retinal Detachment due to Coats Disease in a Teenager with Senior-Loken Syndrome: Case Report and Review of Literature

“…Parlak and Saatci reviewed the use of bevacizumab, ranibizumab, and pegaptanib as an adjuvant treatment with subsequent necessary treatments as mentioned above [10]. There were no reports on the use of aflibercept in children with Coats disease.…”

“…There were no reports on the use of aflibercept in children with Coats disease. Resolution of subretinal fluid and exudation, and regression of telangiectasia had been documented by those patients reviewed by Parlak and Saatci [10].…”

A 12-Year-Old Girl with Bilateral Coats Disease and ABCA4 Gene Mutation

“…The only positive finding was the presence of vitiligo patches throughout her body and extremities. All treatment options were discussed with the family and we decided to treat her with combined bilateral laser photocoagulation and dexamethasone implant (Ozurdex) administration according to our previous positive experience [ 9 , 10 , 11 ]. Under general anesthesia, bilateral indirect laser scatter photocoagulation was administered over all peripheral nonperfused retinal areas.…”