Two-year results of intravitreal injections of aflibercept in Coats' Disease; a case report


Georgakopoulos CD, Foteini T, Makri OE, Vavvas D. Two-year results of intravitreal injections of aflibercept in Coats' Disease; a case report. Retin Cases Brief Rep 2020;

Date Published:

2020 Jun 05


PURPOSE: To report long term results of treatment with intravitreal injections of aflibercept in a newly diagnosed case of Coats' disease. CASE REPORT: An 18-year-old man presented to the Retina Clinic of our Hospital complaining of blurred vision in the right eye (OD) for the past 3 months. His past medical and ocular history were unremarkable. Best corrected visual acuity (BCVA) was 20/200 OD and 20/20 in the left eye. Fundoscopy in OD revealed extensive macular edema with a circinate ring of hard exudates in the posterior pole temporally to the macula. Optical coherence tomography (OCT) demonstrated macular edema with subretinal fluid. Peripheral telangiectasias and light bulb aneurysms in the inferior temporal arcade, as well as in the nasal far periphery were found in OD in fluorescein angiography (FA), confirming the diagnosis of stage 2B Coats' disease. The left eye was normal. The original therapeutic strategy proposed was anti-VEGF injections in OD followed by laser photocoagulation. However, the patient did not consent to laser treatment and was treated with aflibercept monotherapy with 8 monthly intravitreal injections of aflibercept followed by 6 injections every 2 months for a total of 14 injections over a period of 2 years. The BCVA in OD improved to 20/25 while OCT imaging revealed significant decrease in retinal thickness with resolution of macular edema and FA demonstrated prominent regression of aneurysms and leakage. CONCLUSION: To our knowledge this is the first case treated with aflibercept monotherapy, suggesting the significant role of vascular endothelial growth factor (VEGF) in vascular permeability in Coats' and supporting the rationale that anti-VEGFs are a valuable therapeutic option for Coats' disease.

See also: Retina, June 2020, All, 2020
Last updated on 06/30/2020