Mastropasqua Rodolfo, D'Aloisio Rossella, Stanga Paulo Eduardo, Haynes Richard
Bristol Eye Hospital, Bristol, UK.
Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena 41121, Italy.
J Ophthalmol. 2020 Oct 26;2020:8840630. doi: 10.1155/2020/8840630. eCollection 2020.
To assess long-term efficacy of a multiple therapy approach in the treatment and management of unilateral stage 3 Coats disease with exudative retinal detachment.
2 eyes of 2 young patients suffering from unilateral stage 3 Coats disease underwent a multiple therapy approach consisting of surgical drainage of exudative subretinal fluid + one simultaneous and up to one subsequent intravitreal injection of bevacizumab + multiple (up to 3) laser photocoagulation sessions of retinal nonperfusion areas and leaking Coats vasculature.
Complete reabsorption of SRF and retinal reattachment were observed in both cases over the follow-up. In no cases, we observed progression to phthisis bulbi. No bevacizumab-related complications were observed. Epiretinal membrane onset was detected in one eye at the end of follow-up.
The management and treatment of this rare and degenerative disease in young subjects are still a challenge. The described technique is less invasive than conventional intraocular surgery and may be preferable to halt the devastating progression of the disease.
评估多疗法治疗和管理伴有渗出性视网膜脱离的单侧3期科茨病的长期疗效。
2例患有单侧3期科茨病的年轻患者的2只眼睛接受了多疗法,包括手术引流视网膜下渗出液+同时及后续最多1次玻璃体内注射贝伐单抗+对视网膜无灌注区和渗漏的科茨血管进行多次(最多3次)激光光凝治疗。
随访期间,2例患者的视网膜下液均完全吸收,视网膜复位。所有病例均未进展为眼球痨。未观察到与贝伐单抗相关的并发症。随访结束时,1只眼睛检测到视网膜前膜形成。
对年轻患者中这种罕见的退行性疾病的管理和治疗仍然是一项挑战。所描述的技术比传统的眼内手术侵入性小,可能更有利于阻止疾病的破坏性进展。