Klaus Lucke, Silvia Bopp (Bremen, Germany)

Advantages:

To describe surgical procedures and overall relatively good outcomes in advanced cases of Coats’ disease with traction retinal detachment, subretinal exsudation and frequently pucker formation in eyes that unoperated would eventually end up blind.

Methods:

The charts of 17 eyes of 16 patients with advanced Coats’ disease were reviewed retrospectively. All eyes were beyond the stage were laser or cryo treatment could be effective. 12 eyes had macular traction detachment, 3 had a pucker and one eye extensive vitreous opacities as a cause for reduced VA. All eyes had extensive retinal teleangiectasis and exsudative changes in the vitreous and subretinal space. Advanced vitreoretinal surgical techniques including retinectomy and silicone oil tamponade were employed in most of the cases. Follow-up ranged from 4 months to 11 years with a mean of 6 years.

Effectiveness / Safety:

In all but one case the retina could be attached permanently, however, in 8 eyes more than 2 operations were needed and in 8 eyes silicone oil was still in the eye at the end of follow-up. In 7 eyes VA improved and in 6 eyes visual function could at least be stabilized. 4 eyes were functional failures.

Take home message:

A stabilization of the anatomic and functional situation can be achieved even in advanced cases of Coats’-induced traction retinal detachment by vitreoretinal surgery.