title: The effect of intravitreal bevacizumab injection as the initial treatment for Coats' disease.
abstract: BACKGROUND
  In Coats' disease, the most recent development in the treatment has been the intravitreal injection of anti-VEGF agents. The purpose of this article was to evaluate the effect of intravitreal bevacizumab as the initial treatment for Coats' disease in children and adults.
  
  
  METHODS
  The study included 14 pediatric patients and five adult patients with Coats' disease. They were treated with intravitreal bevacizumab (1.25 mg/0.05 ml) as the initial treatment, combined with or without other treatments. The analyses included the evaluation of basic clinical conditions.
  
  
  RESULTS
  In the pediatric group, after a mean of 9.1 months of follow-up, the differences in visual acuity were significant for the comparisons between the baseline examination and the follow-up examinations carried out at weeks 6, 12, and 24 after the baseline (P = 0.006, P = 0.004, P = 0.005 respectively). Vitreoretinal fibrosis was observed in three patients (n = 3, 21.4 %), among whom two showed fibrosis before treatment. All of the pediatric patients showed a resolution of fluid and exudation, and regression of the telangiectasia. In the adult group, after a mean of 10.6 months of follow-up, the differences in visual acuity were not statistically significant (P > 0.05) between the baseline and follow-up examinations. Vitreoretinal fibrosis (n = 2, 40 %) was observed in two patients who both showed fibrosis before treatment. All of the adult patients showed a resolution of fluid and exudation, and regression of the telangiectasia. The differences in the change of BCVA between children and adults were not significant (P > 0.05) during the follow-up examinations.
  
  
  CONCLUSIONS
  The intravitreal injection of bevacizumab as the initial treatment is associated with a measurable gain in visual acuity in patients with Coats' disease. Resolution of the subretinal fluid and exudation, and regression of the telangiectasia were observed in both pediatric and adult patients. Vitreoretinal fibrosis may be one of the natural courses of Coats' disease, and it remains uncertain whether bevacizumab accelerates the fibrosis phenomenon.
authors.affiliation: Department of Ophthalmology, People's Hospital, & Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University, Beijing, China.
authors.forename: Xiao-Xue
authors.initials: XX
authors.lastname: Zheng
authors.forename: Yan-Rong
authors.initials: YR
authors.lastname: Jiang
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D002648:Child; D002675:Child, Preschool; D005260:Female; D005355:Fibrosis; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009887:Ophthalmoscopy; D012160:Retina / Q000473:pathology; D058456:Retinal Telangiectasis / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab