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

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State: Public
Version: author
Serval ID
serval:BIB_6DED20709577
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ranibizumab in the management of advanced Coats disease Stages 3B and 4: long-term outcomes.
Journal
Retina
Author(s)
Gaillard M.C., Mataftsi A., Balmer A., Houghton S., Munier F.L.
ISSN
1539-2864 (Electronic)
ISSN-L
0275-004X
Publication state
Published
Issued date
11/2014
Peer-reviewed
Oui
Volume
34
Number
11
Pages
2275-2281
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
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.
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Create date
11/09/2014 8:46
Last modification date
20/08/2019 15:27
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