The effects of a treatment combination of anti-VEGF injections, laser coagulation and cryotherapy on patients with type 3 Coat's disease

被引:20
作者
Li, Songfeng [1 ]
Deng, Guangda [1 ]
Liu, Jinghua [1 ]
Ma, Yan [1 ]
Lu, Hai [1 ]
机构
[1] Capital Med Univ, Beijing Tongren Hosp, Beijing Tongren Eye Ctr, Beijing Ophthalmol & Visual Sci Key Lab, 1 Dongjiao Min Xiang, Beijing 100730, Peoples R China
关键词
Coats'disease; Treatment; Retinal detachment; Ranibizumab; ENDOTHELIAL GROWTH-FACTOR; RETINAL-DETACHMENT; BEVACIZUMAB;
D O I
10.1186/s12886-017-0469-4
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Background: To examined the curative effect of vitreous injection with ranibizumab, laser coagulation and cryotherapy in treating stage 3 Coats' disease with exudative retinal detachment. Methods: Seventeen patients with stage 3 Coats' disease were enrolled in the study. All eyes were treated with vitreous injection of ranibizumab as initial treatment, and subsequent treatment depended on the absorption of subretinal fluid, Including cryotherapy and laser photocoagulation. Repeat treatment for the two treatment intervals occurred in >= 1 month. The mean follow-up time was 24.12 +/- 5.99 months. The main data evaluation and outcome measurements included the patient's vision, intraocular pressure(IOP), optical coherence tomography (OCT), slit lamp examination, indirect ophthalmoscopy, color Doppler imaging (CDI) and color fundus image analysis. The following variables were compared between groups: abnormal vascular changes, subretinal fluid and exudate absorption, retinal reattachment and complications. The final follow-up results were used to determine the effectiveness of treatment. Results: Of the 17 patients included, 88.24% were male and 11.76% were female. Visual acuity was less than 0.02 in 12 eyes before surgery and 8 eyes after surgery. Visual acuity improved in 7 eyes, accounting for 41.18% of cases, and remained unchanged in 7 eyes, accounting for 41.18% of cases. Three patients were too young to undergo the operation, accounting for 17.65% of cases. The best vision was 0.1. Patients were treated 1 to 5 times for an average of 2. 82 +/- 0.95 times each. There was no statistically significant difference (t = 1.580, p = 0.135) between the preoperative and postoperative intraocular pressures. However, there was a statistically significant difference between the preoperative and postoperative retinal detachment height (2-related samples Wilcoxon signed rank test with z = 3.517, p = 0.000). The results further showed that all patients had different degrees of subretinal fluid absorption, and some of the new blood vessels subsided. All patients were successfully treated with laser and cryosurgery. No ocular or systemic complications were observed during follow-up. Conclusions: Intravitreal ranibizumab (IVR), laser coagulation and cryotherapy were effective in the treatment of Coats' disease with exudative retinal detachment.
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页数:7
相关论文
共 11 条
[1]   Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy [J].
Arevalo, J. F. ;
Maia, M. ;
Flynn, H. W., Jr. ;
Saravia, M. ;
Avery, R. L. ;
Wu, L. ;
Farah, M. Eid ;
Pieramici, D. J. ;
Berrocal, M. H. ;
Sanchez, J. G. .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2008, 92 (02) :213-216
[2]  
Coats G, 1908, Roy Lond Ophthalmol Hosp Rep., V17, P440
[3]   Elevated vascular endothelial growth factor level in Coats' disease and possible therapeutic role of bevacizumab [J].
He, Yu-Guang ;
Wang, Hao ;
Zhao, Biren ;
Lee, Jason ;
Bahl, Dinesh ;
McCluskey, Jessica .
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 2010, 248 (10) :1519-1521
[4]  
Jun Jong Hwa, 2008, Korean J Ophthalmol, V22, P190, DOI 10.3341/kjo.2008.22.3.190
[5]   Expression of Vascular Endothelial Growth Factor in Eyes with Coats' Disease [J].
Kase, Satoru ;
Rao, Narsing A. ;
Yoshikawa, Hiroshi ;
Fukuhara, Junichi ;
Noda, Kousuke ;
Kanda, Atsuhiro ;
Ishida, Susumu .
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 2013, 54 (01) :57-62
[6]   Bevacizumab for Coats' disease with exudative retinal detachment and risk of vitreoretinal traction [J].
Ramasubramanian, Aparna ;
Shields, Carol L. .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2012, 96 (03) :356-359
[7]   Clinical variations and complications of coats disease in 150 cases: The 2000 Stanford Gifford Memorial Lecture [J].
Shields, JA ;
Shields, CL ;
Honavar, SG ;
Demirci, H .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 2001, 131 (05) :561-571
[8]   Classification and management of coats disease: The 2000 Proctor Lecture [J].
Shields, JA ;
Shields, CL ;
Honavar, SG ;
Demirci, H ;
Cater, J .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 2001, 131 (05) :572-583
[9]   Elevated vascular endothelial growth factor levels in Coats disease: rapid response to pegaptanib sodium [J].
Sun, Young ;
Jain, Atul ;
Moshfeghi, Darius M. .
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 2007, 245 (09) :1387-1388
[10]   Increased Nitric Oxide and Vascular Endothelial Growth Factor Levels in the Aqueous Humor of Patients with Coats' Disease [J].
Zhang, Han ;
Liu, Zhe-Li .
JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS, 2012, 28 (04) :397-401