Δημοσίευση

ranibizumab in the management of advanced Coats disease Stages 3B and 4: long-term outcomes.

Τίτλοςranibizumab in the management of advanced Coats disease Stages 3B and 4: long-term outcomes.
Publication TypeJournal Article
Year of Publication2014
AuthorsGaillard, M-C., Mataftsi A., Balmer A., Houghton S., & Munier F. L.
JournalRetina
Volume34
Issue11
Pagination2275-81
Date Published2014 Nov
ISSN1539-2864
Λέξεις κλειδιάAngiogenesis Inhibitors, Antibodies, Monoclonal, Humanized, Chemotherapy, Adjuvant, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Intravitreal Injections, Male, Ranibizumab, Retinal Detachment, Retinal Telangiectasis, Retrospective Studies, Vascular Endothelial Growth Factor A, Visual Acuity
Abstract

BACKGROUND: Laser photocoagulation and cryotherapy to completely destroy telangiectatic vessels and ischemic retina in Coats disease is barely applicable in advanced cases with total retinal detachment, and globe survival is notoriously poor in Stages 3B and 4. Anti-vascular endothelial growth factor intravitreal injections may offer new prospects for these patients.METHODS: This study is a retrospective review of all consecutive patients with Coats disease treated with neoadjuvant or adjuvant intravitreal ranibizumab plus conventional and amblyopia treatment as appropriate.RESULTS: Nine patients (median age, 13 months) presenting Coats Stages 3B and 4 (5 and 4 eyes, respectively) were included. Iris neovascularization resolved within 2 weeks and retinal reapplication within 4 months in all patients. At last follow-up, globe survival was 100% with anatomical success in 8 of the 9 eyes. With a median follow-up of 50 months, fibrotic vitreoretinopathy was developed in 5 of the 9 cases, one leading to tractional retinal detachment and ultimately phthisis bulbi. The remaining 4 of the 9 eyes achieved some vision (range, 0.02-0.063).CONCLUSION: To the best of the authors' knowledge, this is the largest reported series of late-stage Coats undergoing anti-vascular endothelial growth factor therapy, a homogenous cohort of patients treated with a single agent and with the longest follow-up. This study supports the role of ranibizumab in advanced disease by transient restoration of the hemato-retinal barrier and suppression of neovascularization to facilitate classic treatment. At the last follow-up, the authors report unprecedented anatomical success and functional outcome.

DOI10.1097/IAE.0000000000000248
Alternate JournalRetina (Philadelphia, Pa.)
PubMed ID25075562

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