Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease

Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease

Mohamed Nowara,1,2 Yousef A Fouad,1,3 Ihab Abdel Aziz,1,4 Ahmed M Habib,1,3 Mariam Al-feky,1,3 Hisham Hassan1 1Al Mashreq Eye Center, Cairo, Egypt; 2Department of Ophthalmology, Electricity Hospital, Cairo, Egypt; 3Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt; 4Memorial...

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Autores principales: Nowara M, Fouad YA, Abdel Aziz I, Habib AM, Al-feky M, Hassan H
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2021
Materias:
coats’ disease
leber’s miliary aneurysms
exudative retinal detachment
vascular endothelial growth factor
cryotherapy
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/9a7402213187409ea30146e0c7af22d7
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spelling oai:doaj.org-article:9a7402213187409ea30146e0c7af22d72021-12-02T14:17:44ZExperience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease1177-5483https://doaj.org/article/9a7402213187409ea30146e0c7af22d72021-01-01T00:00:00Zhttps://www.dovepress.com/experience-with-intravitreal-ranibizumab-as-an-adjunct-to-ablation-the-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mohamed Nowara,1,2 Yousef A Fouad,1,3 Ihab Abdel Aziz,1,4 Ahmed M Habib,1,3 Mariam Al-feky,1,3 Hisham Hassan1 1Al Mashreq Eye Center, Cairo, Egypt; 2Department of Ophthalmology, Electricity Hospital, Cairo, Egypt; 3Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt; 4Memorial Institute for Ophthalmic Research, Giza, EgyptCorrespondence: Yousef A FouadDepartment of Ophthalmology, Ain Shams University Hospitals, Ramses Street, 11517 Abbasiya, Cairo, EgyptTel +201063781237Email yousef.a.fouad@gmail.comBackground: Coats’ disease is a rare entity with retinal vascular telangiectasia that can progress to exudative retinal detachment, neovascular glaucoma, and a blind painful eye requiring enucleation. Despite recent therapeutic advances decreasing the need for enucleation, no consensus exists about the optimum management of exudative Coats’ disease. The use of intravitreal anti-vascular endothelial growth factor agents as an adjunct to ablation therapy has been shown to achieve favorable outcomes, but some reports suggest an increased incidence of vitreoretinal (VR) fibrosis and tractional retinal detachment (TRD).Methods: We retrospectively reviewed records of patients presenting with exudative Coats’ disease (stages 2 and 3) from April 2016 till November 2020. Extracted data included clinical and radiological assessment, stage (Shields’ classification), interventions, and follow-up.Results: Sixteen eyes were included in the final analysis, of which 4 (25%) were stage 2 and 12 (75%) were stage 3. All eyes underwent intravitreal ranibizumab injection combined with ablation therapy, 14 (87.5%) underwent cryotherapy, 4 (25%) underwent laser ablation, 3 (18.75%) underwent external subretinal fluid drainage, and 3 (18.75%) underwent buckle or vitrectomy surgery. After a median follow-up of 16 months, 11 eyes (68.75%) had complete resolution, 4 (25%) had incomplete resolution, and only one (6.25%) progressed but did not require enucleation. Three eyes (18.75%) developed VR fibrosis, but none progressed to TRD.Conclusion: Combining intravitreal ranibizumab injection with ablation therapy is effective in managing exudative Coats’ disease. External drainage should be preserved for when ablation therapy is not feasible. Future prospective trials with pre-defined outcomes are required.Keywords: Coats’ disease, Leber’s miliary aneurysms, exudative retinal detachment, vascular endothelial growth factor, cryotherapyNowara MFouad YAAbdel Aziz IHabib AMAl-feky MHassan HDove Medical Pressarticlecoats’ diseaseleber’s miliary aneurysmsexudative retinal detachmentvascular endothelial growth factorcryotherapyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 367-373 (2021)
institution DOAJ
collection DOAJ
language EN
topic coats’ disease
leber’s miliary aneurysms
exudative retinal detachment
vascular endothelial growth factor
cryotherapy
Ophthalmology
RE1-994
spellingShingle coats’ disease
leber’s miliary aneurysms
exudative retinal detachment
vascular endothelial growth factor
cryotherapy
Ophthalmology
RE1-994
Nowara M
Fouad YA
Abdel Aziz I
Habib AM
Al-feky M
Hassan H
Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease
description Mohamed Nowara,1,2 Yousef A Fouad,1,3 Ihab Abdel Aziz,1,4 Ahmed M Habib,1,3 Mariam Al-feky,1,3 Hisham Hassan1 1Al Mashreq Eye Center, Cairo, Egypt; 2Department of Ophthalmology, Electricity Hospital, Cairo, Egypt; 3Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt; 4Memorial Institute for Ophthalmic Research, Giza, EgyptCorrespondence: Yousef A FouadDepartment of Ophthalmology, Ain Shams University Hospitals, Ramses Street, 11517 Abbasiya, Cairo, EgyptTel +201063781237Email yousef.a.fouad@gmail.comBackground: Coats’ disease is a rare entity with retinal vascular telangiectasia that can progress to exudative retinal detachment, neovascular glaucoma, and a blind painful eye requiring enucleation. Despite recent therapeutic advances decreasing the need for enucleation, no consensus exists about the optimum management of exudative Coats’ disease. The use of intravitreal anti-vascular endothelial growth factor agents as an adjunct to ablation therapy has been shown to achieve favorable outcomes, but some reports suggest an increased incidence of vitreoretinal (VR) fibrosis and tractional retinal detachment (TRD).Methods: We retrospectively reviewed records of patients presenting with exudative Coats’ disease (stages 2 and 3) from April 2016 till November 2020. Extracted data included clinical and radiological assessment, stage (Shields’ classification), interventions, and follow-up.Results: Sixteen eyes were included in the final analysis, of which 4 (25%) were stage 2 and 12 (75%) were stage 3. All eyes underwent intravitreal ranibizumab injection combined with ablation therapy, 14 (87.5%) underwent cryotherapy, 4 (25%) underwent laser ablation, 3 (18.75%) underwent external subretinal fluid drainage, and 3 (18.75%) underwent buckle or vitrectomy surgery. After a median follow-up of 16 months, 11 eyes (68.75%) had complete resolution, 4 (25%) had incomplete resolution, and only one (6.25%) progressed but did not require enucleation. Three eyes (18.75%) developed VR fibrosis, but none progressed to TRD.Conclusion: Combining intravitreal ranibizumab injection with ablation therapy is effective in managing exudative Coats’ disease. External drainage should be preserved for when ablation therapy is not feasible. Future prospective trials with pre-defined outcomes are required.Keywords: Coats’ disease, Leber’s miliary aneurysms, exudative retinal detachment, vascular endothelial growth factor, cryotherapy
format article
author Nowara M
Fouad YA
Abdel Aziz I
Habib AM
Al-feky M
Hassan H
author_facet Nowara M
Fouad YA
Abdel Aziz I
Habib AM
Al-feky M
Hassan H
author_sort Nowara M
title Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease
title_short Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease
title_full Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease
title_fullStr Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease
title_full_unstemmed Experience with Intravitreal Ranibizumab as an Adjunct to Ablation Therapy in Eyes with Exudative Coats’ Disease
title_sort experience with intravitreal ranibizumab as an adjunct to ablation therapy in eyes with exudative coats’ disease
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/9a7402213187409ea30146e0c7af22d7
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