Abstract
Purpose :
To investigate the longer-term effectiveness of 577-nm yellow laser in pediatric Coats disease, and examine the rate of complications, recurrences, and the use of adjuvant treatments.
Methods :
A retrospective chart review was conducted with IRB approval of patients under 18 years of age with Coats disease, treated with yellow laser, during a 12-year period. Clinical characteristics, complications, recurrences, and treatments in addition to yellow laser were recorded.
Results :
Sixty-nine eyes of 67 patients met inclusion criteria. Coats disease stage at diagnosis was Stage 1 in 3, Stage 2A in 7, Stage 2B in 24, Stage 3A1 in 14, Stage 3A2 in 10, and Stage 3B in 11 eyes. Mean age at initial treatment was 6.7 years. The mean length of follow-up was 46.7 months (median 28.7, range 5.5-161.8 months). Eyes underwent an average of 2.7 laser treatments prior to treatment conclusion. Laser was performed using both paint and scatter techniques (Figure 1-2) in 62 eyes, while 4 and 3 eyes had only scatter or paint technique, respectively. An average of 2.3 intravitreal bevacizumab injections were used in 15 eyes, as indicated for foveal threatening exudate (n=13) or iris neovascularization (n=2). Full treatment, defined as complete resolution of subretinal fluid and visible telangiectasias, was achieved in 60 eyes (87.0%) at a mean time of 11.0 months. Recurrences requiring additional treatment occurred in 6 eyes at a mean of 45.0 months. Three eyes had surgical intervention with external drainage, and one eye had scleral buckle with vitrectomy. Complications occurred in 11 eyes, including cataract (n=7), neovascular glaucoma (n=2), vitreous hemorrhage (n=2), tractional or rhegmatogenous retinal detachment (n=4), and epiretinal membrane (n=1). Complications were less likely to occur in Stage 1-2B (n=2, 5.9%) compared with Stages 3A1-3B (n=9, 25.7%), which was statistically significant (p=0.045).
Conclusions :
Use of 577-nm yellow laser with or without adjunctive interventions is an effective and durable long-term treatment for Coats disease. Complications are uncommon but more likely to occur in cases of exudative retinal detachment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.