title: TRANSCLERAL DRAINAGE OF SUBRETINAL FLUID, ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR, AND WIDE-FIELD IMAGING-GUIDED LASER IN COATS EXUDATIVE RETINAL DETACHMENT.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of combined transscleral drainage of subretinal fluid (SRF) with intravitreal bevacizumab and laser photocoagulation in the management of advanced Coats disease (Stage 3) with exudative retinal detachment.
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  Retrospective case review of eight eyes in eight children with advanced Coats disease manifested as total or subtotal retinal detachment. All eyes initially underwent surgical drainage of exudative SRF followed by intravitreal injection of bevacizumab and laser photocoagulation. Patients were subsequently followed up for up to 60 months.
  
  
  RESULTS
  In all eyes, after SRF drainage and administration of one to two intravitreal injections, SRF was completely eliminated. Patients required up to four sessions of laser photocoagulation. Retinal detachment consequently reduced with all patients showing total retinal reattachment and resolution of the subretinal exudates. At the last follow-up, no patient showed recurrent SRF and no ocular complications related to bevacizumab nor evidence of further disease progression were noted.
  
  
  CONCLUSIONS
  The authors present a new therapeutic approach that allows for the first time successful treatment of advanced cases of exudative retinal detachment in Coats disease without the need for vitrectomy. Transscleral drainage of SRF accompanied by anti-vascular endothelial growth factor injection and laser photocoagulation appears to be successful in halting progression of advanced Coats disease with exudative detachment and a less invasive approach when compared with conventional management.
authors.affiliation: *Manchester Royal Eye Hospital, Manchester, United Kingdom; †Manchester Vision Regeneration (MVR) Lab at NIHR/Wellcome Trust Manchester CRF, Manchester, United Kingdom; ‡Manchester Academic Health Science Centre and Centre for Ophthalmology and Vision Research, Institute of Human Development, University of Manchester, Manchester, United Kingdom; and §School of Medicine, University of Manchester, Manchester, United Kingdom.
authors.forename: Paulo E
authors.initials: PE
authors.lastname: Stanga
authors.forename: Horj
authors.initials: H
authors.lastname: Jaberansari
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Bindra
authors.forename: Maria
authors.initials: M
authors.lastname: Gil-Martinez
authors.forename: Susmito
authors.initials: S
authors.lastname: Biswas
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D012163:Retinal Detachment / Q000628:therapy*; D058456:Retinal Telangiectasis / Q000628:therapy*; D012189:Retrospective Studies; D058471:Subretinal Fluid; D013396:Suction / Q000379:methods*; D025321:Surgery, Computer-Assisted; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A