Effect of intravitreal triamcinolone in advanced coats disease

Abstract

Purpose: : To report our experience with intravitreal triamcinolone (IVTA) in cases of advanced Coats disease with massive subretinal exudation (MSRE)

Methods: : Two eyes of two cases of advanced Coats disease, one eye with stage 4 disease and one with stage 5, received IVTA. One eye received 1mg and one received 4mg IVTA. Because of the age and the limited space between the lens and the remaining vitreous cavity, the injections were performed under general anesthesia with ultrasound guidance.

Results: : Both eyes had MSRE with total bullous retinal detachment that was almost touching the crystalline lens. One eye had neovascular glaucoma. IVTA was associated with almost total resolution of the subretinal fluid within 4 weeks from the injection. Subsequent application of ablative therapy without the need for surgical drainage was successfully performed on both eyes. None of the patients developed side effects from the treatment.

Conclusions: : Our findings suggest that IVTA may be an effective alternative to surgical drainage in advanced cases of Coats disease. To our knowledge, 1mg of IVTA has not been previously reported in this setting. Larger prospective studies to address the dose, safety and efficacy of IVTA in the management of advanced Coats disease are needed.