J Korean Ophthalmol Soc.  2009 Apr;50(4):630-634. 10.3341/jkos.2009.50.4.630.

Intravitreal Bevacizumab Injection in Adult Coats' Disease

• Park YS
• Sohn JH
• Lim HW
• Lee BR

• KMID: 2212267
• DOI: http://doi.org/10.3341/jkos.2009.50.4.630

Abstract

PURPOSE: To report the efficacy of intravitreal bevacizumab injection in adult patients with Coats' disease.
CASE SUMMARY
Vascular telangiectasia, microaneurysms, circinate hard exudates, and macular edema were shown in the macula of two patients. Vascular abnormality was limited to < or =6 clock hours in both cases. In case 1, the temporal retina demonstrates filigree-like vessels and capillary nonperfusion. In case 2, the nasal retina demonstrates aneurysmal dilatation and multiple microaneurysms. Intravitreal bevacizumab injection was administered in both cases. After 1 month, macular edema decreased. Laser photocoagulation was performed for vascular telangiectasia, microaneurysms, and capillary nonperfusion area. Then an additional decrease of macular edema was observed. Fluorescein leakage decreased, as well. After 1 month (case 1) and 2 months (case 2), macular edema increased. The second and third intravitreal reinjections were administered to each patient. Macular edema decreased.
CONCLUSIONS
We report two rare cases of Coats' disease in adult patients. Intravitreal bevacizumab injection in patients with Coats' disease can result in a rapid decrease of macular edema, which will then lead to rapid visual recovery and an opportunity for effective laser photocoagulation. We recommend that intraviteal bevacizumab injection be used in combination with laser photocoagulation for the treatment of Coats' disease.

Keyword

Coats' disease; Intravitreal bevacizumab injection; Laser photocoagulation

MeSH Terms

Adult
Aneurysm
Antibodies, Monoclonal, Humanized
Capillaries
Dilatation
Exudates and Transudates
Fluorescein
Humans
Light Coagulation
Macular Edema
Retina
Telangiectasis
Bevacizumab
Antibodies, Monoclonal, Humanized
Fluorescein

Figure

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  Figure 1. Case 1. (A) Capillary telangiectasia, microaneurysms, and circinate hard exudates are shown (in the right eye). (B) Angiographic photograph shows leakage in the telangiectactic vessels and microaneurysms. And temporal retina demonstrates filigreelike vessels and capillary nonperfusion. (C) Three optical coherence tomographic images of the right eye show improvement of macular edema before (top), 1 month after (middle) intravitreal bevacizumab injection, and 6 weeks after laser photocoagulation. (bottom). (D) 1 month after the third intravitreal bevacizumab injection, angiographic photograph shows decrease of leakage.

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  Figure 2. Case 2. (A) Capillary telangiectasia, microaneurysms, and circinate hard exudates are shown (in the right eye). And aneurysmal dilatation of the inferotemporal retinal artery is also shown. (B) Angiographic photograph shows leakage in the telangiectatic vessels and microaneurysms. And the nasal retina demonstrates aneurysmaldilation and multiple microaneurysm. (C) Three optical coherence tomographic images of the right eye showing improvement of macular edema before (top), 1 month after (middle) intravitreal bevacizumab injection, and 1 month after laser photocoagulation (bottom). (D) After laser photocoagulation and intravitreal bevacizumab injection, photograph shows decrease of microaneuryms. And aneurysmal dilatation of inferotemporal retinal artery shows decrease of size.

Reference

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