June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Surgical outcomes of combined pars plana vitrectomy and scleral buckling in eyes with advanced Coats’ disease and Coats’-like exudative retinal detachment associated with facioscapulohumeral muscular dystrophy
Author Affiliations & Notes
  • Austen N Knapp
    Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States
  • Prethy Rao
    Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan, United States
  • Bozho Todorich
    Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan, United States
  • Antonio Capone
    Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan, United States
    Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States
  • Footnotes
    Commercial Relationships   Austen Knapp, None; Prethy Rao, None; Bozho Todorich, None; Antonio Capone, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4149. doi:
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      Austen N Knapp, Prethy Rao, Bozho Todorich, Antonio Capone; Surgical outcomes of combined pars plana vitrectomy and scleral buckling in eyes with advanced Coats’ disease and Coats’-like exudative retinal detachment associated with facioscapulohumeral muscular dystrophy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4149.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Surgical options for advanced Coats’ and Coats’-like detachments are limited and outcomes unpredictable. We describe a surgical technique and its anatomic outcomes for total retinal detachment in advanced Coats’ disease and Coats-like exudative retinal detachment associated with facioscapulohumeral muscular dystrophy (FSHD).

Methods : This was a retrospective, consecutive interventional surgical case series of six eyes of five patients with stage 4 Coats’ Disease and Coats’-like exudative detachment associated with FSHD who underwent combined 20 or 23G pars plana vitrectomy, endolaser, and encircling scleral buckle (PPV/EL/SB) by a single surgeon at our institution between 2010-2016. We reviewed patients’ medical records, intraoperative color fundus photography and angiography to determine rate of retinal reattachment and leakage pre- and post procedure. Herein, we describe the surgical technique and long-term clinical outcomes.

Results : Of the 6 eyes, 2 (33.3%) had FSHD. Average age was 4.1 years (1.2-9.1) with mean follow-up of 37.8 months (1.4-137). Of 6 eyes undergoing an initial PPV/EL/SB, 5 (83.3%) received concurrent perfluorocarbon and external drainage, two (33.3%) received silicone oil (SO), and two (33%) received anti-vascular endothelial growth factor (anti-VEGF) at initial surgery.

At the final visit, all eyes exhibited macular attachment and 4 eyes (66.7%) had >50% total retinal attachment. Both FSHD eyes required a second vitrectomy with SO placement for recurrent retinal detachments. There were no recurrent total detachments requiring surgery in the Coats’-only group. All six eyes underwent subsequent green argon laser treatment with an average of 2.4 treatments (range, 1-4) during the follow up period for postoperative leakage. One eye (16.7%) developed glaucoma requiring cyclocryophotocoagulation. One FSHD eye developed an iatrogenic break at initial surgery, and one Coats’ only eye developed a peripheral stretch break without proliferative vitreoretinopathy which was observed at final visit.

Conclusions : Combined PPV/EL/SB may be a potential surgical option in achieving initial anatomic attachment in challenging Coats’ and Coats’-like total detachments associated with FSHD.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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