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coats_disease [2020/10/19 00:49] – created Scott Larsoncoats_disease [2025/06/14 02:28] (current) – [References] Scott Larson
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 ^ Stage  |     ^ Fundus Features                                                      ^ ^ Stage  |     ^ Fundus Features                                                      ^
 | 1      |     | Retinal telangiectasia only                                          | | 1      |     | Retinal telangiectasia only                                          |
-| 2      |     | Telangiectasia and Exudation Extrafoveal exudation Foveal exudation  | +| 2      |     | Telangiectasia and Exudation   | 
-| :::    | A   | :::                                                                  | +| :::    | A   | Extrafoveal exudation                                                                  | 
-| :::    | B   | :::                                                                  |+| :::    | B   | Foveal exudation                                                                  |
 | 3      |     | Exudative Retinal Detachment                                         | | 3      |     | Exudative Retinal Detachment                                         |
 | :::    | A   | Subtotal detachment                                                  | | :::    | A   | Subtotal detachment                                                  |
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 | :::    | B   | Total retinal detachment                                             | | :::    | B   | Total retinal detachment                                             |
 | 4      |     | Total retinal detachment and glacuoma                                | | 4      |     | Total retinal detachment and glacuoma                                |
-| 5      |     | Advanced end-stage disease (phthisis with pain                                           |+| 5      |     | Advanced end-stage disease (phthisis with pain)                                           |
  
 [[https://pubmed.ncbi.nlm.nih.gov/11336931/|Adapted from Shields JA, Shields CL, Honavar S, Demirci H. Classification and management of Coats disease: The 2000 Proctor Lecture. Am J Ophthalmol 2001;131:572-83]] [[https://pubmed.ncbi.nlm.nih.gov/11336931/|Adapted from Shields JA, Shields CL, Honavar S, Demirci H. Classification and management of Coats disease: The 2000 Proctor Lecture. Am J Ophthalmol 2001;131:572-83]]
  
 +===== Laser Treatment =====
 +  * Diode 532nm recommended by Shapiro et al. 
 +    * Power generally 400 to 750 mW
 +    * Duration 1000 ms
 +    * Rapid interval cycles to simulate near continuous treatment 
 +    * endpoint: telangiectatic vessel whitening  
 +  * Diode 810nm recommended by Villegas et al. 
 +    * Large (1.2 mm) spot size 
 +    * Power typically around 350 mW
 +    * treat entire surface of telangiectatic vessels and/or exudative detachment as well as the avascular retina. 
 +    * endpoint: complete whitening of the telangiectatic vessels 
 +    * add bevacizumab 1.25 mg
 +
 +===== Anti-VEGF Treatment =====
 +  * adjunctive treatment 
 +  * 1.25 mg via pars plana
 +
 +
 +===== References =====
 +  - [[https://1drv.ms/b/c/31d83ae8e55e0542/EbQL4qb2jgRHpLfDb7bdM3cBanWi8XdjsoCYW3CGHhLKDw?e=mrQGYx |Coats disease: An overview of classification, management and outcomes.  Indian J Ophthalmolol. 2019 Jun;67(6):763-771]]
 +  - [[https://1drv.ms/b/c/31d83ae8e55e0542/EYWMiz1F575OnSCB3W_aURYBIZXLY3LcliXXKPS9iHFMlA?e=ZnU1G9 |Advanced Coats’ disease treated with intravitreal bevacizumab combined with laser vascular ablation.  Clinical Ophthalmology 2014:8;973-976]]
 +  - https://1drv.ms/b/c/31d83ae8e55e0542/EfAH56QMqQVPhMKbQmtwVVcBCvsKaSRLX-AI2zQoc2dG_w?e=bfAzNc |Effects of Green Diode Laser in the Treatment of Pediatric Coats Disease. Shapiro et al.   Am J Ophthalmolol 2011;151:725-731]]
 +  - [[https://1drv.ms/b/c/31d83ae8e55e0542/EQxi43WL5vVHn2MiCIqED2sBa5RFX5cC2hzMd2E4xmiCfA?e=Ut7luD|Current Management of Coats Disease, Survey of Ophthalmology 2014;59:30-46]]
 +  - [[https://1drv.ms/b/c/31d83ae8e55e0542/EV5OeaBAJI5IlNyReDAHbJkBwX7HAeuMnxXm2XkSxQRVDQ?e=CNOJgm |Selective photocoagulation in Coats’ disease: ten-year follow-up. Eur J Ophthalmol 2002;12:501-5]]