Intravitreal Ranibizumab as an Adjunctive Treatment for Coats Disease (6-Year Follow-Up)

Abstract

Elevated vascular endothelial growth factor levels have been demonstrated in Coats disease. Anti-vascular endothelial growth factor agents assist to the decrease of vascular permeability of the capillary endothelial cells, thus increasing the efficiency of laser application.

Management of Coats’ disease with RazumabTM (World’s first biosimilar ranibizumab) and laser photocoagulation: A case report

“…8 Giannakopoulos and colleagues reported the long-term results of Coats' disease after treatment with ranibizumab and demonstrated a visual acuity of 20/20 with no exudates or edema at 20 months of follow-up; the patient was stable at 6 years of follow-up. 13 Biosimilar ranibizumab with laser photocoagulation significantly reduced the exudation, angioma-like lesions, CMT and edema in retina, and improved visual acuity in a patient with Coats' disease. The current case provides insights for biosimilar ranibizumab based options for Coats' disease, which needs to be further studied.…”

“…The use of anti-VEGF agents may enhance the activity of laser therapy by decreasing the vascular permeability of the capillary endothelial cells. 13 The treatment goal in the Coats' disease is focused at managing the telangiectatic vessels to control and resolve intra and sub-retinal exudates and eventually vision salvation. 2 The patient, in the present case-scenario, demonstrated vision recovery in the right eye where both intravitreal biosimilar ranibizumab and laser therapy were employed compared to no improvement in the left eye, which was managed using laser therapy only.…”

Retinoschisis in Coats Disease: Clinical Picture, Therapeutic Considerations, and Management Outcomes

“…Adjuvant intravitreal anti-VEGF therapy and steroid injections have also been shown to hasten the progress of active disease. 16 For far advanced disease, PPV with silicone oil tamponade has been shown to be effective in maintaining or achieving good visual outcomes. 13,[17][18][19] Retinoschisis or macrocyst associated with Coats disease has been described earlier.…”

Intravitreal Ranibizumab Injection and Retinal Laser Photocoagulation Treatment for Adult-Onset Coats Disease

“…4 Although the etiology remains unknown, it is suggested that Coats telangiectasis is secondary to a somatic mutation in chromosome Xp 11.2. 5 Coats disease treatment depends on the stage of the disease classified by the Shields classification and the time of clinical diagnosis. 1 It is really infrequent that Coats disease is diagnosed at Stage 1, where photocoagulation or cryotherapy is considered to be effective with a favorable visual outcome.…”

“…6 However, vascular endothelial growth factor concentration has been reported to be increased in anterior chamber and vitreous of patients with Coats disease contributing to an increased vascular permeability of the capillary endothelial cells. 5 Thus anti-vascular endothelial growth factor drugs are being reported as an effective agent for an alternative way to help fluid drainage. 5,6 Our patient, classified at the 3A stage of Coats disease, presented with intraretinal and subretinal exudates and exudative retinal detachment with already macular involvement.…”