Search

Background and Objective: The authors investigate the efficacy of combination treatment with laser photocoagulation, intravitreal bevacizumab (IVB) (Avastin; Genentech, South San Francisco, CA), and sub-Tenon corticosteroids in Coats' disease., Patients and Methods: Patient records at the Bascom Palmer Eye Institute were reviewed from August 2002 to January 2014. Primary outcome measures were anatomic success, globe salvage, and final visual acuity., Results: Of the 26 patients (26 eyes) reviewed, 20 patients had stage 3A2, four patients had stage 3A1, and two patients had stage 2A. Mean follow-up time was 2.26 years. The median number of applications was five and three for laser and IVB, respectively. Five patients received sub-Tenon triamcinolone injections. Global salvage was achieved in all patients. Final visual acuity outcomes were reasonable: 20/20 to 20/50 in five patients, 20/60 to 20/100 in five patients, and 20/200 or less in 16 patients., Conclusion: Intravitreal injections of bevacizumab used in combination with repetitive laser photocoagulation therapy yielded anatomic success, global salvage, and reasonable visual acuity outcomes. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:443-449.]., (Copyright 2016, SLACK Incorporated.)

Background and Objective: To investigate the clinical course and outcomes of patients with vitreomacular traction (VMT) managed initially by observation., Patients and Methods: This noncomparative case series included patients with a diagnosis of VMT based on clinical symptoms and findings on spectral-domain optical coherence tomography (SD-OCT) between 2005 and 2014. VMT was documented using a standardized grading system based on the degree of distortion of the foveal contour. Data were collected at five retina clinics using standardized collection forms. Visual acuity, changes in SD-OCT findings, and timing of the release of VMT as seen on SD-OCT were recorded., Results: The study included 230 eyes of 185 patients. Mean age was 72.5 years, and mean follow-up was 32 months. At baseline, VMT grading was grade 1 in 92 eyes (40%), grade 2 in 118 eyes (51.3%), and grade 3 in 20 eyes (8.7%). By last follow-up, spontaneous release of VMT occurred in 73 eyes (31.7%). Spontaneous release of VMT occurred at a mean of 18 months (median: 10.9 months) after initial visit. Mean logMAR best corrected visual acuity (BCVA) was 0.28 (20/55) (range: 20/20 to 20/400) at baseline and 0.25 (20/51) (range: 20/20 to 20/400) at last follow-up. Pars plana vitrectomy was performed in 10 eyes (4.1%) for macular hole (six eyes) and increased VMT (four eyes); BCVA was at least 20/40 in eight of the 10 eyes at last follow-up., Conclusion: Patients with VMT generally had a favorable clinical course when managed initially by observation. Spontaneous release of VMT occurred in approximately one-third of patients. At last follow-up, pars plana vitrectomy was performed in fewer than 5% of patients., (Copyright 2015, SLACK Incorporated.)

The authors describe a 34-month-old boy who presented with a bilateral and asymmetric exudative retinopathy with similarities to Coats’ disease. The patient’s medical history was remarkable for hypotonia, developmental delay, seizures, and intracranial calcifications. Genetic testing revealed a diagnosis of Coats’ plus. This rare genetic disease should be in the differential diagnosis in patients who present with a bilateral and asymmetric Coats’-like retinopathy in the presence of other systemic abnormalities.

This is a report of a 5-year-old boy who presented with an exudative retinopathy consistent with Coats' disease. Optical coherence tomography confirmed the concurrent presence of retinoschisis in the same eye, adjacent to the areas of exudation and ischemia. Treatment with laser photocoagulation, corticosteroids, and anti-VEGF therapy led to the resolution of the schisis cavity 1 year later. This represents the second published account of retinoschisis in the setting of Coats' disease., (Copyright 2014, SLACK Incorporated.)

The pigmented fundus lesions associated with familial adenomatous polyposis (FAP) often resemble those characteristic of congenital hypertrophy of the retinal pigment epithelium (CHRPE). However, some fundus lesions in FAP resemble hamartomatous lesions of the retinal pigment epithelium (RPE). Intraretinal extension of the RPE is a feature not seen in CHPRE lesions that may be unique to some of the pigmented lesions of FAP. The authors report the spectral-domain optical coherence tomography findings of the pigmented ocular lesions associated with FAP in a 10-year-old boy.

The authors present the case of a 6-month-old female infant with a known diagnosis of incontinentia pigmenti with a normal examination by indirect ophthalmoscopy. However, fluorescein angiography revealed vascular abnormalities that were not detected by indirect ophthalmoscopy. Follow-up examination revealed progressive vascular changes that again were only detectable by fluorescein angiography. Because vision loss can cause significant morbidity in incontinentia pigmenti, the use of fluorescein angiography as an adjunctive tool with exams under anesthesia may provide invaluable information in the detection of early vascular changes in this disease., (Copyright 2013, SLACK Incorporated.)