Ranibizumab in the Management of Advanced Coats Disease Stages 3b and 4

Gaillard, Marie-Claire; Mataftsi, Asimina; Balmer, Aubin; Houghton, Susan; Munier, Francis L.

doi:10.1097/iae.0000000000000248

Cited by 49 publications

(31 citation statements)

References 20 publications

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“…18,19,20 It has been shown that VEGF levels are elevated in the aqueous humour in Coats’ disease and increase significantly as the disease progresses. 21 Histopathologic examinations have revealed macrophages in the subretinal space and increased vascular permeability caused by these cells, in addition to increased expression of VEGF, which leads to angiogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…Even in patients with stage 3B and 4 disease, adjuvant or neoadjuvant application of intravitreal ranibizumab may lead to partial visual recovery. 20 However, there remains the fact that combination therapy with intravitreal anti-VEGF injection may result in vitreoretinal fibrosis and tractional retinal detachment. 23 Laser photocoagulation and cryotherapy were also the most common treatment modalities in the current case series, especially in earlier stage disease.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Follow-Up and Treatment Results in Coats’ Disease

Cebeci

Bayraktar

Yılmaz

et al. 2016

tjo

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Objectives:The aim of this study was to evaluate the clinical features, follow-up and treatment results of patients diagnosed with Coats’ disease.Materials and Methods: Medical records of 27 patients diagnosed with Coats’ disease in our clinic were reviewed retrospectively. All patients underwent complete ophthalmological examination and fundus photography was taken. Disease stage and treatment methods used were recorded.Results:Twenty-seven eyes of 27 patients were included in the study. Mean age was 9.03 years; 21 patients were male and 6 were female. Three patients were older than 18 years old. Based on the Shields classification, 1 (3.7%) eye was stage 2A, 4 (14.8%) eyes were stage 2B, 6 (22.2%) were stage 3A1, 3 (11.1%) were stage 3A2, 1 (3.7%) was stage 3B, 4 (14.8%) were stage 4 and 8 (29.6%) were stage 5. Fourteen patients underwent treatment, 12 of whom had combined therapy. The most common treatment modalities were laser photocoagulation and cryotherapy. Encircling band was done in one patient and pars plana vitrectomy in 3 patients. Enucleation was done in 5 patients.Conclusion:Coats’ disease is a chronic disease and main goal of treatment is to eliminate the vascular anomalies and their complications using repetitive combination therapies. Treatment in the early stages can lead to functional success, and in advanced stages can result in a salvageable eye.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of Follow-Up and Treatment Results in Coats’ Disease

Cebeci

Bayraktar

Yılmaz

et al. 2016

tjo

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“…Previous studies revealed that monthly injections could rapidly stabilize the symptoms [9–11]. Therefore, we utilized the anti-VEGF intravitreal injection as the initial treatment, then maintained a monthly follow-up period, and finally decided a reinjection according to the disease progress in patients.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the safety and efficacy data for ranibizumab in Coats’ disease is yet lacking, especially for children and the advanced Coats’ disease (stage 3 and over) [9, 10]. Conbercept is a recombinant fusion protein with a high affinity for all VEGF isoforms and has become a common therapy for the treatment of retinal diseases in China.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of conbercept or ranibizumab intravitreal injection combined with laser therapy for Coats’ disease

Zhang

Wang

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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PurposeThe current treatment approaches for Coats’ disease by intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents (ranibizumab or conbercept) combined with laser therapy were evaluated for the efficacy during the treatment.MethodsThe medical records of 28 patients diagnosed with Coats’ disease followed by the treatment with intravitreal injection of anti-VEGF agents and laser therapies at Tianjin Medical University Eye Hospital and Hebei Eye Hospital during July 2012 and October 2017 were reviewed retrospectively. Clinical outcomes were recorded with a minimum follow-up of 6 months. The patients were divided into ranibizumab- and conbercept-treated groups, as well as based on age: pediatric and adult groups.ResultTwenty-eight patients were involved in this study. The average number of the injections was 2.82 ± 0.98. Laser photocoagulation was conducted in all patients, and the average number of lasers was 2.63 ± 0.74. The average follow-up period was 24.29 ± 9.85 months. Fourteen patients (50%) were stable, 12 (43%) patients were improved, and 2 patients (7%) showed recurred subretinal fluid and exudation. The final best corrected visual acuity (BCVA) increased markedly after intravitreal injection of ranibizumab or conbercept combined with laser therapy (p = 0.029, p = 0.009, respectively). The number of injections and lasers between conbercept and ranibizumab groups did not vary significantly (p = 0.160, p = 0.573, respectively). Nine patients (60%) in the ranibizumab-treated group and five (38%) in the conbercept-treated group reached a stable phase, and five (33%) and seven (54%) patients got the vision improved after treated with ranibizumab or conbercept, respectively. In pediatric and adult groups, the initial and final BCVA differed significantly (p = 0.03, p = 0.008, respectively). However, the injection number was remarkably different (p = 0.02), while the laser numbers did not have any markedly difference (p = 0.38).ConclusionIntravitreal injection of ranibizumab or conbercept combined with laser therapy is an effective therapeutic option in Coats’ disease. Moreover, the intravitreal injection of ranibizumab or conbercept had no significant adverse effects and appeared to offer visual improvement in Coats’ disease.

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“…Experience with ranibizumab is limited in Coats' disease when compared to bevacizumab (Table1). In the largest published case series, Gaillard et al [28] treated 9 patients with severe Coats' disease in stage 3B (5 eyes) and stage 4 (4 eyes) with adjunctive intravitreal ranibizumab in addition to conventional ablative therapy. They observed a progressive retinal reattachment in all cases on an average of 2 months after the injection, which facilitated further treatments, like cryotherapy and laser photocoagulation.…”

Section: E G F I N H I B I T O R S ( B E V a C I Z U M A B Ranibimentioning

confidence: 99%

A Review of Intravitreal Treatment Alternatives Used as an Adjunctive Therapy in Coats' Disease

Parlak

Saatçi

2015

International Journal of Ophthalmic Research

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AIM:To review the intravitreal treatment alternatives used as an adjunctive therapy in Coats' disease. CONTEXT: The goal of therapy in Coats' disease is essentially to obliterate all retinal nonperfused areas and ablate retinal vascular abnormalities in order to provide subretinal fluid resolution and regression of hard exudates whenever feasible. However, both antiVEGFs and steroids are also administered intravitreally to improve the anatomic and functional outcome in cases with Coats' disease by many clinicians nowadays. METHODS: A comprehensive literature search in the databases of Pubmed and Cochrane Library was conducted in July 2015 to obtain all manuscripts related to Coats' disease and intravitreal treatment. Results: Among 71 search results, 34 relevant studies, predominately in the form of case reports and small case series were included. These were evaluated in detail and summarized in this report. CONCLUSIONS: There is a growing body of literature on the use of intravitreal agents as an adjunctive treatment for Coats' disease. However there is still open questions, particularly regarding the drug choice and long-term safety. Coming years will ascertain the place of intravitreal pharmacotherapy, which may find a niche in the treatment armamentarium of Coats' disease.

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Ranibizumab in the Management of Advanced Coats Disease Stages 3b and 4

Cited by 49 publications

References 20 publications

Evaluation of Follow-Up and Treatment Results in Coats’ Disease

Evaluation of Follow-Up and Treatment Results in Coats’ Disease

The efficacy of conbercept or ranibizumab intravitreal injection combined with laser therapy for Coats’ disease

A Review of Intravitreal Treatment Alternatives Used as an Adjunctive Therapy in Coats' Disease

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