Outcomes of combined medial and laser treatment for advanced Coat’s disease
Reviewed by Fiona Rowe

In this study, the anatomical and visual outcomes of paediatric patients with advanced stage 3+ Coat’s disease are reported. Patients were treated with a combination of intravitreal ranibizumab, laser photocoagulation and methyl prednisolone acetate. This was a retrospective review of 16 eyes (16 patients) over 2008 to 2017 including 14 males and two females with mean age of 5.12 ±2.7 years. All had monocular disease with six stage 3A and 10 stage 3B. Mean follow-up was 45.43 ±29.01 months. Nine patients had visual acuities of counting fingers to no light perception. Seven had acuities of 20/400 to 20/50. Mean laser treatment applications was 2.67, mean intravitreal injections was 3.92 and mean prednisolone infusions was 3.41. Ocular complications included temporary intraocular pressure increase (n=6), and one eye with cataract. Visual acuity improved in six, remained stable in six and deteriorated in four. All had reduction in vascular leakage, resolution of peripheral telangiectasias and retinal detachment. Combined treatment in this study allowed globe salvage and may reduce the need for surgical intervention.

Treatment of advanced Coat’s disease with combination therapy of laser photocoagulation, intra-vitreal Ranibizumab and sub-tenon methyl prednisolone acetate.
Petroni S, Catena G, Iarossi G et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2022;59(3):187-91.