Efficacy of Aflibercept in Bevacizumab-Resistant Macular Edema in Adult-Onset Coats Disease

Author:

Ku Cristy A.1,Lema Gareth M.2

Affiliation:

1. Department of Ophthalmology, Ira G. Ross Eye Institute, Jacobs School of Medicine and Biomedical Sciences, The State University of New York at Buffalo, Buffalo, NY, USA

2. Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA

Abstract

Purpose: This case is the first to our knowledge that demonstrates the efficacy of intravitreal aflibercept in bevacizumab-resistant, laser-naive macular edema (ME) in adult-onset Coats disease. Methods: A retrospective case report is presented. Results: A 74-year-old woman presented with central visual distortion in her right eye. Imaging and exam were consistent with adult-onset Coats disease with unilateral telangiectatic vessels, numerous macroaneurysms, and peripheral capillary dropout. There were also ME, lipid exudate, and localized hemorrhage. ME failed to respond to 4 intravitreal injections of bevacizumab but dramatically improved following initiation of aflibercept, with patient deferral of laser photocoagulation. Conclusions: To our knowledge, this is the first reported case of aflibercept as the sole treatment of bevacizumab-resistant ME in adult-onset Coats disease. Given the localized macular involvement more common to adult-onset Coats disease, antivascular endothelial growth factor (anti-VEGF) therapy may be sufficient, compared with classic childhood Coats disease, in which anti-VEGF therapy serves as an adjunct to laser photocoagulation or cryotherapy.

Publisher

SAGE Publications

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