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Management of stage 3B Coats disease: presentation of a combined treatment modality and long-term follow-up

  • Pediatrics
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Abstract

Purpose

To present a combined treatment modality in the management of stage 3B Coats disease and to evaluate its efficacy in the long-term follow-up.

Methods

This study was a retrospective review of 29 eyes from 29 consecutive patients who had stage 3B Coats disease with total exudative retinal detachment (ERD). The combined treatment modality consisted of external drainage of subretinal fluid (SRF), followed by endolaser photocoagulation via a nonvitrectomy approach, and intravitreal ranibizumab injection. Final disease status, anatomic success, and final visual acuity were the main outcome measures.

Results

The treated eyes initially received one session of external drainage of SRF, followed by an average of 1.4 sessions (range, 1 to 3 sessions) of endolaser photocoagulation and intravitreal ranibizumab injection. With a median follow-up period of 40 months (range, 21–81 months), all eyes demonstrated no disease progression, including 6 eyes that required vitrectomy with silicone oil tamponade due to increasing ERD after initial treatment. No enucleation was required. At the final follow-up, anatomic success with retinal reattachment and no active disease was achieved in 24 of 29 eyes (82.8%). Fibrosis was observed in 22 eyes (75.9%) with a mean onset time of 9 months (range, 5–16 months); of these, 3 and 9 eyes developed tractional retinal detachment and epiretinal membrane, respectively. In 62.1% of the eyes, the final visual acuity was only light perception or no light perception.

Conclusion

The combined treatment modality presented in this study is an effective way in the management of stage 3B Coats disease with total ERD.

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Funding

This study was supported by the Shanghai Science and Technology Commission (17411952900) and Shanghai Shen Kang Hospital Development Center (16CR4017A).

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Author notes

  1. Tingyi Liang and Jie Peng contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Tingyi Liang, Jie Peng, Qi Zhang, Xiuyu Zhu, Yu Xu & Peiquan Zhao

Authors
  1. Tingyi Liang
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  2. Jie Peng
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  3. Qi Zhang
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  4. Xiuyu Zhu
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  5. Yu Xu
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  6. Peiquan Zhao
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Corresponding author

Correspondence to Peiquan Zhao.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Liang, T., Peng, J., Zhang, Q. et al. Management of stage 3B Coats disease: presentation of a combined treatment modality and long-term follow-up. Graefes Arch Clin Exp Ophthalmol 258, 2031–2038 (2020). https://doi.org/10.1007/s00417-020-04739-z

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  • DOI: https://doi.org/10.1007/s00417-020-04739-z

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