Elevated vascular endothelial growth factor levels in Coats disease: rapid response to pegaptanib sodium

Abstract

Coats disease may have a component of dysregulation of VEGF-mediated angiogenesis as evidenced by elevated levels in this patient.

Expression of Vascular Endothelial Growth Factor in Eyes with Coats' Disease

“…1,5,6 Moreover, the elevated VEGF levels in the vitreous decreased markedly after the injection of an anti-VEGF agent. 1,5 Thus, the pathogenesis and progression of the disease are possibly regulated by VEGF secretion into the ocular fluid. Although anti-VEGF treatments may be a significant option for patients with Coats' disease, it is an enigma that immunolocalization of VEGF has yet to be elucidated in eyes with Coats' disease.…”

“…Together with a previous publication on VEGF, a major product of activated macrophages in the pathology of AMD, 10 these results suggest that macrophages play a critical role in the promotion of vascular permeability and angiogenesis by expressing VEGF in Coats' disease. Indeed, previous reports have demonstrated that the VEGF protein concentration was high in subretinal fluid in patients with Coats' disease, 1,5,6 correlated with the location of infiltrating macrophages and VEGF immunolocalization.…”

“…In fact, injections of intravitreal anti-VEGF antibody contributed to the improvement of exudation, hemorrhage, and reattachment of the retina in selected patients. 1,5 Subsequent studies have demonstrated that elevated VEGF levels were observed in intraocular fluid, such as subretinal fluid, vitreous, and aqueous humor of Coats' disease. 1,5,6 Moreover, the elevated VEGF levels in the vitreous decreased markedly after the injection of an anti-VEGF agent.…”

“…1,5 Subsequent studies have demonstrated that elevated VEGF levels were observed in intraocular fluid, such as subretinal fluid, vitreous, and aqueous humor of Coats' disease. 1,5,6 Moreover, the elevated VEGF levels in the vitreous decreased markedly after the injection of an anti-VEGF agent. 1,5 Thus, the pathogenesis and progression of the disease are possibly regulated by VEGF secretion into the ocular fluid.…”

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

“…Sun et al [19] , reported of a 2-year-old boy with stage 4 Coats' disease, who had undergone an unsuccessful scleral buckle surgery with cryotherapy. A dramatic response was obtained after two intravitreal pegaptanib injections.…”