Department of Ophthalmology, People's Hospital, & Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University, Beijing, China.
Graefes Arch Clin Exp Ophthalmol. 2014 Jan;252(1):35-42. doi: 10.1007/s00417-013-2409-1. Epub 2013 Jul 20.
In Coats' disease, the most recent development in the treatment has been the intravitreal injection of anti-VEGF agents. The purpose of this article was to evaluate the effect of intravitreal bevacizumab as the initial treatment for Coats' disease in children and adults.
The study included 14 pediatric patients and five adult patients with Coats' disease. They were treated with intravitreal bevacizumab (1.25 mg/0.05 ml) as the initial treatment, combined with or without other treatments. The analyses included the evaluation of basic clinical conditions.
In the pediatric group, after a mean of 9.1 months of follow-up, the differences in visual acuity were significant for the comparisons between the baseline examination and the follow-up examinations carried out at weeks 6, 12, and 24 after the baseline (P = 0.006, P = 0.004, P = 0.005 respectively). Vitreoretinal fibrosis was observed in three patients (n = 3, 21.4 %), among whom two showed fibrosis before treatment. All of the pediatric patients showed a resolution of fluid and exudation, and regression of the telangiectasia. In the adult group, after a mean of 10.6 months of follow-up, the differences in visual acuity were not statistically significant (P > 0.05) between the baseline and follow-up examinations. Vitreoretinal fibrosis (n = 2, 40 %) was observed in two patients who both showed fibrosis before treatment. All of the adult patients showed a resolution of fluid and exudation, and regression of the telangiectasia. The differences in the change of BCVA between children and adults were not significant (P > 0.05) during the follow-up examinations.
The intravitreal injection of bevacizumab as the initial treatment is associated with a measurable gain in visual acuity in patients with Coats' disease. Resolution of the subretinal fluid and exudation, and regression of the telangiectasia were observed in both pediatric and adult patients. Vitreoretinal fibrosis may be one of the natural courses of Coats' disease, and it remains uncertain whether bevacizumab accelerates the fibrosis phenomenon.
在 Coats 病的治疗中，最近的发展是玻璃体内注射抗血管内皮生长因子（VEGF）药物。本文旨在评估玻璃体内注射贝伐单抗作为儿童和成人 Coats 病初始治疗的效果。
本研究纳入了 14 例儿童患者和 5 例成人 Coats 病患者。他们均接受玻璃体内注射贝伐单抗（1.25mg/0.05ml）作为初始治疗，联合或不联合其他治疗。分析包括基本临床情况的评估。
在儿科组中，平均随访 9.1 个月后，与基线检查相比，在基线后 6、12 和 24 周的随访检查中视力的差异具有统计学意义（P=0.006，P=0.004，P=0.005）。3 例（n=3，21.4%）患儿出现玻璃体视网膜纤维化，其中 2 例在治疗前即有纤维化。所有儿科患者均表现为液体和渗出物消退，毛细血管扩张症消退。在成年组中，平均随访 10.6 个月后，视力的差异在基线和随访检查之间无统计学意义（P＞0.05）。2 例（40%）患者出现玻璃体视网膜纤维化，均在治疗前有纤维化。所有成年患者均表现为液体和渗出物消退，毛细血管扩张症消退。在随访检查中，儿童和成年患者的最佳矫正视力（BCVA）变化差异无统计学意义（P＞0.05）。
玻璃体内注射贝伐单抗作为初始治疗与 Coats 病患者的视力提高相关。在儿科和成年患者中均观察到视网膜下液和渗出物的消退以及毛细血管扩张症的消退。玻璃体视网膜纤维化可能是 Coats 病的自然病程之一，尚不确定贝伐单抗是否加速了纤维化现象。
