Subretinal fluid drainage combined with intravitreal injection of anti-vascular endothelial growth factor in treatment of severe exudative retinal detachment Coats disease / 眼科新进展

ABSTRACT

Objective To investigate the effects of subretinal fluid drainage combined with intravitreal anti-vascular endothelial growth factor (VEGF) drugs in the treatment of severe exudative retinal detachment Coats disease.Methods Thirteen patients (13 eyes) with 3B Coats' disease diagnosed at the Eye Center of Tongren Hospital were included in the study.The participants were aged from 1 year to 11 years with a mean age of (4.15 ± 2.99) years.The visual acuity was no light perception in 1 case,from light perception to counting finger in 7 cases,from 0.01 to 0.1 in 2 cases,and could not be measured due to young in 3 cases.Patients underwent retinal fluid drainage combined with intravitreal ranibizumab (IVR,0.5 mg,0.05 mL) at the pars plana of ciliary body,and with retinal laser photocoagulation or cryotherapy according to the retinal peripheral vascular activity.During the follow-up,the visual acuity,intraocular pressure,slit lamp,indirect ophthalmoscope and color ophthalmoscope were examined and observed.The abnormal blood vessel change,absorption of subretinal fluid,retinal reattachment and complication were observed.Results Two subretinal fluid drainage were performed in 3 cases,one subretinal fluid drainage in 10 cases.Six cases were combined with two intravitreal injections,4 cases with three intravitral injection,3 cases with intravitreal injection for more than three times.Five cases were treated with simple photocoagulation,3 cases with simple retinal cryotherapy,and 5 cases with laser combined with cryotherapy.In 13 patients,the visual acuity was improved in 2 cases,unchanged in 8 cases,and could not be measured due to young in 3 cases.Eight cases had complete retinal reattachment.No significant postoperative complications occurred during follow-up,such as endophthalmitis,retinal hole and vitreous hemorrhage.Conclusion Subretinal fluid drainage combined with intravitreal injection is an effective method for severe 3B stage Coats disease.