Kim Jongshin, Park Kyu Hyung, Woo Se Joon
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2010 Dec;24(6):374-6. doi: 10.3341/kjo.2010.24.6.374. Epub 2010 Nov 23.
A 68-year-old woman presented with a visual field defect in her right eye. The fundus of her right eye showed multiple telangiectatic vessels, retinal hemorrhages, and subretinal exudates in the inferior peripheral retina. Nine months later, the subretinal exudates extended to the fovea despite treatment with laser photocoagulation. Cryotherapy was not possible at the time because of the posterior location of the retinal telangiectatic vessels. She was treated with a combination of photodynamic therapy (PDT) and intravitreal bevacizumab injection: three injections were given at 2-month intervals. After this combined therapy, her right fundus revealed a significant regression of abnormal retinal vessels and subretinal exudates. A fluorescein angiography showed no leakage from the abnormal retinal vessels. At 9 months after the combined therapy, she was able to maintain a stable visual acuity and visual field. This is the first case report that demonstrates the efficacy of the combined treatment of PDT and intravitreal bevacizumab injection in Coats's disease. This combined therapy is a kind of treatment modality for adult Coats' disease in cases which cryotherapy cannot be employed and are refractory to laser photocoagulation.
一名68岁女性因右眼视野缺损就诊。其右眼眼底显示周边下部视网膜有多处毛细血管扩张、视网膜出血和视网膜下渗出。尽管接受了激光光凝治疗，但9个月后视网膜下渗出物仍蔓延至黄斑中心凹。由于视网膜毛细血管扩张位于后部，当时无法进行冷冻疗法。她接受了光动力疗法（PDT）和玻璃体内注射贝伐单抗联合治疗：每隔2个月注射3次。联合治疗后，其右眼眼底显示异常视网膜血管和视网膜下渗出物明显消退。荧光素血管造影显示异常视网膜血管无渗漏。联合治疗9个月后，她能够保持稳定的视力和视野。这是首例证明PDT和玻璃体内注射贝伐单抗联合治疗科茨病疗效的病例报告。这种联合治疗是一种用于成人科茨病的治疗方式，适用于无法进行冷冻疗法且对激光光凝治疗无效的病例。
