Abstract
BackgroundTo evaluate the effectiveness of endolaser photocoagulation by a two-port pars plana nonvitrectomy approach for treating Coats’ disease with shallow exudative retinal detachment.MethodsThis study included 24 patients (23 boys with an age range of 2–17 years, and one girl, age 6 years) with stage 3 Coats’ disease (25 eyes) from December 2012 and May 2014 at a single center. All of the 25 eyes were complicated with serous or total retinal detachment and received none-vitrectomized endolaser: two (23- or 25-gauge) incisions were routinely made 3 mm posterior to the corneal limbus and a laser was applied directly on the abnormal blood vessels. Additional treatments included subretinal fluid drainage (five eyes), intravitreal triamcinolone injection (seven eyes), and intravitreal anti-vascular endothelial growth factor (VEGF) injection (17 eyes). Best-corrected visual acuity, intraocular pressure, and fundus and abnormal vascular changes were recorded to determine therapeutic effects.ResultsTwenty-four out of the 25 treated eyes (96 %) had retina reattached. The number of treatment sessions differed case by case (1–5 sessions, average 1.96) and the time to full treatment of retinal reattachment was 4 months in average. One patient (4 %) presented with retinal redetachment. Five (20 %) eyes received further laser treatment with indirect ophthalmoscope and four eyes (16 %) presented with total retinal detachment at their first visits received consecutive treatments. At the end of the follow-up period (mean, 10.08 months), telangiectasias of 24 (96 %) eyes were resolved and no severe complications occurred.ConclusionsEndolaser photocoagulation by a two-port pars plana nonvitrectomy approach is an effective treatment for advanced Coats’ disease with serous retinal detachment. The long-term safety of the approach needs further investigation.
Highlights
In 1908, George Coats [1] described an ocular entity characterized by unilateral retinal vascular abnormalities and retinal exudation usually in boys
All of them presented with serous or total retinal detachment that could not be reached by regular laser photocoagulation and undertook minimally invasive operations of endolaser photocoagulation
Some cases were treated combined with drainage of the subretinal fluid, intravitreal triamcinolone injection or anti-vascular endothelial growth factor (VEGF) injection
Summary
In 1908, George Coats [1] described an ocular entity characterized by unilateral retinal vascular abnormalities and retinal exudation usually in boys. Coats’ disease is associated with excessive production of yellowish intraretinal and subretinal exudates [2] and can cause retinal detachment and severe visual loss [3]. 2, telangiectasia and exudation (2A, extrafoveal exudation; 2B, foveal exudation); stage 3, exudative retinal detachment (3A, subtotal; 3B, total); stage 4, total detachment and secondary glaucoma; and stage 5, advanced end-stage disease. Disease, including diathermy, laser photocoagulation, cryotherapy, subretinal fluid drainage, scleral buckling surgery, pars plana vitrectomy, and intravitreal anti-vascular endothelial growth factor (VEGF) therapy [6,7,8]. To evaluate the effectiveness of endolaser photocoagulation by a two-port pars plana nonvitrectomy approach for treating Coats’ disease with shallow exudative retinal detachment
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