Skip to main content


Log in

Elevated vascular endothelial growth factor level in Coats’ disease and possible therapeutic role of bevacizumab

  • Case Report
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript



To compare intraocular vascular endothelial growth factor (VEGF) level in patients with and without Coats’ disease, and to report a case of Coats’ disease that responded to intravitreal injection of bevacizumab.


Intraocular fluid was obtained from four eyes with Coats’ disease (subretinal fluid in three eyes and aqueous in one eye) and from five eyes with rhegmatogenous retinal detachment (subretinal fluid in four eyes and vitreous in one eye). Intraocular VEGF level was compared between these two groups. In one eye with stage 2B Coats’ disease, macular edema, visual acuity, and intraocular VEGF level were compared before and after intravitreal injection of bevacizumab.


Mean intraocular VEGF level in eyes with Coats’ disease was 2,394.5 pg/ml, compared to 15.3 pg/ml in eyes with rhegmagenous retinal detachment. In the eye with stage 2B Coats’ disease, macular edema was reduced after bevacizumab injection, and the visual acuity improved from 0.05 to 0.2. Intraocular VEGF level decreased from 1247 pg/ml to 20.4 pg/ml 1 month after the injection.


Coats’ disease is associated with increased intraocular VEGF level. Bevacizumab may be a valuable adjunctive treatment for Coats’ disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1


  1. Shields JA, Shields CL (2001) Review: Coats' disease. The 2001 LuEsther T. Mertz lecture. Retina 22:80–91

    Article  Google Scholar 

  2. Silodor SW, Augsburger JJ, Shields JA et al (1988) Natural history and management of advanced Coats’ disease. Ophthalmic Surg 19:89–93

    CAS  PubMed  Google Scholar 

  3. Schefler AC, Berrocal AM, Murray TG (2008) Advanced Coats’ disease: management with repetitive aggressive laser ablation therapy. Retina 28:S28–S41

    Article  Google Scholar 

  4. Jun JH, Kim YC, Kim KS (2008) Resolution of severe macular edema in adult Coats’ disease with intravitreal triamcinolone and bevacizumab injection. Korean J Ophthalmol 22:190–193

    Article  PubMed  Google Scholar 

  5. Cakir M, Cekic O, Yilmaz F (2008) Combined intravitreal bevacizumab and triamcinolone injection in a child with Coats disease. Journal of AAPOS 12:309–311

    Article  PubMed  Google Scholar 

  6. Venkatesh P, Mandal S, Garg S (2008) Management of Coats' disease with bevacizumab in 2 patients. Can J Ophthalmol 43:245–246

    Article  PubMed  Google Scholar 

  7. Sun Y, Jain A, Moshfeghi DM (2007) Elevated vascular endothelial growth factor levels in Coats disease: rapid response to pegaptanib sodium. Graefes Arch Clin Exp Ophthalmol 245:1387–1388

    Article  CAS  PubMed  Google Scholar 

  8. Luhmann UFO, Lin J, Acar N, Lammel S, Feil S, Grimm C, Seeliger MW, Hammes HP, Berger W (2005) Role of the Norrie disease pseukoglioma gene in sprouting angiogenesis during development of the retinal vasculature. Invest Ophthalmol Vis Sci 46:3372–3382

    Article  PubMed  Google Scholar 

  9. Black GC, Perveen R, Bonshek R, Cahill M, Clayton-Smith J, Lloyd C, McLeod D (1999) Coats’ disease of the retina (unilateral retinal telangiectasis) caused by somatic mutation in the NDP gene: a role for norrin in retinal angiogenesis. Hum Mol Genet 8:2031–2035

    Article  CAS  PubMed  Google Scholar 

  10. Kaul S, Uparkar M, Mody K, Walinjkar J, Kothari M, Natarajan S (2010) Intravitreal anti-vascular endothelial growth factor agents as an adjunct in the management of Coats’ disease in children. Indian J Ophthalmol 58:76–78

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Yu-Guang He.

Additional information

Grant fund in support of the study

Research to Prevent Blindness, Inc., NY, NY and “Zora Meagher Macular Degeneration Research Professorship”, Dallas, TX.

Proprietary interest


The authors have full control of all primary data, and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review the data if requested.

Rights and permissions

Reprints and permissions

About this article

Cite this article

He, YG., Wang, H., Zhao, B. et al. Elevated vascular endothelial growth factor level in Coats’ disease and possible therapeutic role of bevacizumab. Graefes Arch Clin Exp Ophthalmol 248, 1519–1521 (2010).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: