Evaluation of the effectiveness of combination treatment for Coats’ retinitis

The aim of this study is to evaluate the efficacy of a combined treatment modality for Coats’ disease, integrating anti-angiogenic therapy with retinal laser photocoagulation.
The presented clinical case illustrates the advantages of a combined, staged treatment approach for Coats’ disease. A marked increase in exudative manifestations within the macular region and along the inferior-temporal vascular arcade, observed following the initial session of retinal laser photocoagulation (which included barrier and delimiting applications to the macula), would have precluded subsequent laser intervention without a significant risk of complications. Consequently, the administration of anti-VEGF agents as adjuvant therapy proved optimal for establishing favorable conditions for the next stage of laser photocoagulation. Given that the clinical course of Coats’ disease in adult patients is frequently associated with hypercholesterolemia, performing a lipid profile and initiating appropriate corrective measures for any identified dyslipidemia is essential. This management also contributes to the reduction of cholesterol exudation. Thus, the implemented combined, staged treatment regimen in this patient resulted in the stabilization of the pathological process and the preservation of high visual acuity.
Conclusion. Laser photocoagulation remains the primary treatment for Coats’ disease. However, the use of anti-VEGF agents, either as neoadjuvant or adjuvant therapy, facilitates the stabilization of the pathological process and aids in the preservation of the patient’s maximum potential visual function.

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