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Combined photodynamic therapy and intravitreal bevacizumab injection for the treatment of adult Coats' disease: a case report.

Kim J, Park KH, Woo SJ - Korean J Ophthalmol (2010)

Bottom Line: After this combined therapy, her right fundus revealed a significant regression of abnormal retinal vessels and subretinal exudates.A fluorescein angiography showed no leakage from the abnormal retinal vessels.At 9 months after the combined therapy, she was able to maintain a stable visual acuity and visual field.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
A 68-year-old woman presented with a visual field defect in her right eye. The fundus of her right eye showed multiple telangiectatic vessels, retinal hemorrhages, and subretinal exudates in the inferior peripheral retina. Nine months later, the subretinal exudates extended to the fovea despite treatment with laser photocoagulation. Cryotherapy was not possible at the time because of the posterior location of the retinal telangiectatic vessels. She was treated with a combination of photodynamic therapy (PDT) and intravitreal bevacizumab injection: three injections were given at 2-month intervals. After this combined therapy, her right fundus revealed a significant regression of abnormal retinal vessels and subretinal exudates. A fluorescein angiography showed no leakage from the abnormal retinal vessels. At 9 months after the combined therapy, she was able to maintain a stable visual acuity and visual field. This is the first case report that demonstrates the efficacy of the combined treatment of PDT and intravitreal bevacizumab injection in Coats's disease. This combined therapy is a kind of treatment modality for adult Coats' disease in cases which cryotherapy cannot be employed and are refractory to laser photocoagulation.

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Related in: MedlinePlus

Sequential changes in the distance between subretinal exudates and the fovea before and after photodynamic therapy (PDT). After PDT, the lesion-to-fovea distance increased gradually.DD=disc diameter.
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Figure 2: Sequential changes in the distance between subretinal exudates and the fovea before and after photodynamic therapy (PDT). After PDT, the lesion-to-fovea distance increased gradually.DD=disc diameter.

Mentions: At 2 months post-PDT, a second intravitreal bevacizumab injection was given. At 4 months post-PDT, a third intravitreal bevacizumab injection was given and an additional scatter laser photocoagulation was applied to the area where the pre-existing abnormal retinal vessels and subretinal exudates had been located. At 6 months post-PDT, a fundus examination of the right eye showed a significant regression of the abnormal retinal vessels and subretinal exudates (Fig. 1B). At 9 months post-PDT, the subretinal exudates withdrew further from the fovea and the patient's visual acuity remained stable with a BCVA of 20/25 in both eyes (Figs. 1C and 2).


Combined photodynamic therapy and intravitreal bevacizumab injection for the treatment of adult Coats' disease: a case report.

Kim J, Park KH, Woo SJ - Korean J Ophthalmol (2010)

Sequential changes in the distance between subretinal exudates and the fovea before and after photodynamic therapy (PDT). After PDT, the lesion-to-fovea distance increased gradually.DD=disc diameter.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992568&req=5

Figure 2: Sequential changes in the distance between subretinal exudates and the fovea before and after photodynamic therapy (PDT). After PDT, the lesion-to-fovea distance increased gradually.DD=disc diameter.
Mentions: At 2 months post-PDT, a second intravitreal bevacizumab injection was given. At 4 months post-PDT, a third intravitreal bevacizumab injection was given and an additional scatter laser photocoagulation was applied to the area where the pre-existing abnormal retinal vessels and subretinal exudates had been located. At 6 months post-PDT, a fundus examination of the right eye showed a significant regression of the abnormal retinal vessels and subretinal exudates (Fig. 1B). At 9 months post-PDT, the subretinal exudates withdrew further from the fovea and the patient's visual acuity remained stable with a BCVA of 20/25 in both eyes (Figs. 1C and 2).

Bottom Line: After this combined therapy, her right fundus revealed a significant regression of abnormal retinal vessels and subretinal exudates.A fluorescein angiography showed no leakage from the abnormal retinal vessels.At 9 months after the combined therapy, she was able to maintain a stable visual acuity and visual field.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
A 68-year-old woman presented with a visual field defect in her right eye. The fundus of her right eye showed multiple telangiectatic vessels, retinal hemorrhages, and subretinal exudates in the inferior peripheral retina. Nine months later, the subretinal exudates extended to the fovea despite treatment with laser photocoagulation. Cryotherapy was not possible at the time because of the posterior location of the retinal telangiectatic vessels. She was treated with a combination of photodynamic therapy (PDT) and intravitreal bevacizumab injection: three injections were given at 2-month intervals. After this combined therapy, her right fundus revealed a significant regression of abnormal retinal vessels and subretinal exudates. A fluorescein angiography showed no leakage from the abnormal retinal vessels. At 9 months after the combined therapy, she was able to maintain a stable visual acuity and visual field. This is the first case report that demonstrates the efficacy of the combined treatment of PDT and intravitreal bevacizumab injection in Coats's disease. This combined therapy is a kind of treatment modality for adult Coats' disease in cases which cryotherapy cannot be employed and are refractory to laser photocoagulation.

Show MeSH
Related in: MedlinePlus