Elevated vascular endothelial growth factor level in Coats' disease and possible therapeutic role of bevacizumab.
OBJECTIVE
To compare intraocular vascular endothelial growth factor (VEGF) level in patients with and without Coats' disease, and to report a case of Coats' disease that responded to intravitreal injection of bevacizumab.


METHODS
Intraocular fluid was obtained from four eyes with Coats' disease (subretinal fluid in three eyes and aqueous in one eye) and from five eyes with rhegmatogenous retinal detachment (subretinal fluid in four eyes and vitreous in one eye). Intraocular VEGF level was compared between these two groups. In one eye with stage 2B Coats' disease, macular edema, visual acuity, and intraocular VEGF level were compared before and after intravitreal injection of bevacizumab.


RESULTS
Mean intraocular VEGF level in eyes with Coats' disease was 2,394.5 pg/ml, compared to 15.3 pg/ml in eyes with rhegmagenous retinal detachment. In the eye with stage 2B Coats' disease, macular edema was reduced after bevacizumab injection, and the visual acuity improved from 0.05 to 0.2. Intraocular VEGF level decreased from 1247 pg/ml to 20.4 pg/ml 1 month after the injection.


CONCLUSIONS
Coats' disease is associated with increased intraocular VEGF level. Bevacizumab may be a valuable adjunctive treatment for Coats' disease.
He
Yu-Guang
YG
Department of Ophthalmology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75390-9057, USA. Yuguang.He@UTSouthwestern.edu
Wang
Hao
H
Zhao
Biren
B
Lee
Jason
J
Bahl
Dinesh
D
McCluskey
Jessica
J
D000328:Adult; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001082:Aqueous Humor / Q000378:metabolism*; D000068258:Bevacizumab; D001826:Body Fluids / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000378:metabolism; D012164:Retinal Diseases / Q000188:drug therapy / Q000378:metabolism*; D012171:Retinal Vessels / Q000473:pathology; D013684:Telangiectasis / Q000188:drug therapy / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000378:metabolism*; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab