Abstract
Purpose
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.
Methods
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.
Results
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.
Conclusion
Coats’ disease is associated with increased intraocular VEGF level. Bevacizumab may be a valuable adjunctive treatment for Coats’ disease.
References
Shields JA, Shields CL (2001) Review: Coats' disease. The 2001 LuEsther T. Mertz lecture. Retina 22:80–91
Silodor SW, Augsburger JJ, Shields JA et al (1988) Natural history and management of advanced Coats’ disease. Ophthalmic Surg 19:89–93
Schefler AC, Berrocal AM, Murray TG (2008) Advanced Coats’ disease: management with repetitive aggressive laser ablation therapy. Retina 28:S28–S41
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
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
Venkatesh P, Mandal S, Garg S (2008) Management of Coats' disease with bevacizumab in 2 patients. Can J Ophthalmol 43:245–246
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
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
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
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
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Grant fund in support of the study
Research to Prevent Blindness, Inc., NY, NY and “Zora Meagher Macular Degeneration Research Professorship”, Dallas, TX.
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None
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.
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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). https://doi.org/10.1007/s00417-010-1366-1
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DOI: https://doi.org/10.1007/s00417-010-1366-1