Abstract

P 284

Combined intravitreous therapy with bevacizumab and triamcinolone in Coats disease.

Michael R. R. Böhm, Holger Busse, Constantin E. Uhlig
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Münster

Objective
An 26-year old male patient presented with acute unilateral decrease of visual acuity due to Coats disease with macular edema and central hemorrhage. Because of the localization, retinal laserphotocoagulation or kryoretinopexie were avoided and off label intravitreal injections performed.
Methods
Visual acuity (VA, Snellen-letters, 5m distance), slit-lamp examination, funduscopy, fluorescein-angiography (FA), ocular coherence tomography (OCT), fullfield-electroretinography (ff-ERG). Medical treatment was started with combined intravitreal injection of bevazicumab (50µl) and triamcinolone (25µl), followed by two intravitreal injections of bevazicumab (50µl) in monthly periods. Follow-up was 6 months.
Results
At baseline, VA was 0.3. Following first intravitreal treatment, VA improved to 0.7, and central retinal thickness decreased from 500 µm to 380 µm. VA further increased  to 1.0 after the second bevacizumab-injection and subsequently remained stable likewise the retinal thickness. No local or systemic unwarranted side effects were observed.
Conclusions
Combined intravitreal treatment with bevacizumab and triamcinolon resulted in significant visual and morphological improvement over six months and was possible without serious systemic or local side effects. If such a treatment achieves continuous retinal stability has to be investigated in further studies.

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