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Journal List > J Korean Ophthalmol Soc > v.58(7) > 1010822

Kim, Shin, and Park: Intravitreal Ranibizumab Injection in Adult-onset Coats' Disease: A Case Report

Abstract

Purpose

To report a case of adult-onset Coats' disease which showed decreased retinal edema and improved visual acuity following intravitreal ranibizumab injection.

Case summary

A 21-year-old woman visited our hospital for decreased visual acuity in left eye from 3 months ago. Her best corrected visual acuity was 1.0 in the right eye, and 0.4 in the left eye. The intraocular pressure was 19 mmHg in the right eye and 16 mmHg in the left eye. At anterior segment examination, no abnormal findings were found. On fundus examination, subretinal exudates, superior retinal edema at posterior pole, and telangiectasia along superortemporal vascular arcade were observed in the left eye. Upon diagnosis as Coats' disease, intravitreal ranibizumab was performed, and laser photocoagulation was done around the retinal telangiectasia and nonperfusion area. Then, the second and third intravitreal ranibizumab injections were performed by a month, and her best visual acuity was improved to 0.8 and optical coherence tomography revealed decreased retinal edema.

Conclusions

We report a case of adult-onset Coats' disease. Intravitreal ranibizumab injection is effective in rapid visual improvement and decrease of retinal edema as combination therapy with laser photocoagulation which was a generalized treatment of choice in Coats' disease. J Korean Ophthalmol Soc 2017;58(7):870–874

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jkos-58-870f1.tif
Figure 1.
Fundus photographs of left eye. (A) Fundus photograph of left eye at initial visit reveals subretinal exudates at posterior pole, and telangiectasia along superortemporal vascular arcade. (B) No definite improvement was observed at a month after first intravitreal ranibizumab injection and photocoagulation.
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jkos-58-870f2.tif
Figure 2.
Optical coherence tomographs of the left eye. (A) The optical coherence tomography at the first visit shows subretinal exudates and superior macular edema. (B) A month after intravitreal ranibizumab injection, macular edema decreased. (C) A month after second intravitreal ranibizumab injection, macular edema more decreased.
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jkos-58-870f3.tif
Figure 3.
Fluorescein angiographs of the left eye. (A) Fluorescein angiographs of the left eye at initial visit shows retinal telangiectasia at posterior pole, and late leakage, nonperfusion area at peripheral retina. (B) Late leakage was shown at similar area at a month after third intravitreal ranibizumab injection.
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