Using cryotherapy and intravitreal triamcinolone injection to treat Coats' disease with exudative retinal detachment

Abstract

Objective To evaluate the effects of retinal cryotherapy and intravitreal triamcinolone injection to treat Coats' disease with exudative retinal detachment. Methods This was a prospective consecutive case study, and 21 patients (21 eyes) with Coats' disease accompanied by exudative retinal detachment were enrolled. There were 19 males and two females patients, aged from two to 18 years.Fifteen eyes had partial retinal detachment (stage 3A) and six eyes had total retinal detachment (stage 3B).All patients underwent eryocoagulation and intravitreal triamcinolone injection. Three eyes underwent sclerotomy to drain subretinal fluid. Four eyes underwent further treatment by photocoagulation or cryotherapy for the residual abnormal blood vessels after the surgery. The follow-up ranged from three to 15 months with an average of seven months. Visual acuity, intraocular pressure, eye position and eye movements, slit lamp microscope, indirect ophthalmoscope and color fundus imaging were followed up. The last follow-up time was considered as the judgment time for the therapeutic effects. Results Six eyes had increased intraocular pressure after the surgery, which was controlled by local drug treatment. At the end of follow-up, 19 eyes had reattached retina, one eye had partial retinal detachment and one eye had total retinal detachment. The vision improved in three eyes, unchanged in 14 eyes, and decreased in two eyes. Other complications included strabismus (one eye) and cataract (four eyes). Conclusion The combined treatment of cryotherapy and intravitreal triamcinolone injection is an effective therapy for the Coats' disease with exudative retinal detachment, as retina reattaches and visual function is saved in most patients after this treatment. Key words: Retinal diseases/surgery; Retinal detachment/surgery; Cryotherapy/methods; Triamcinolone acetonide/therapeutic use; Coats' disease