We report long-term results of treatment with
intravitreal injection of
aflibercept in a newly diagnosed case of adult-onset
Coats' disease. A 40-year-old Philipino male was referred to our Eye Center complaining of vision reduction for the past three months in his right eye. Examination revealed visual acuity of 0.1 in the affected right eye with normal vision of 1.0 in his left eye. Fundal examination of the right eye showed temporal
retinal telangiectasia with massive exudation reaching the macula. The left fundal examination was normal. The patient's optical coherence tomography (OCT) demonstrated massive exudative thickening. The patient was managed with one
intravitreal injection of
aflibercept followed by focal
laser, with successful anatomical and subjective outcomes that were maintained after three years.
Aflibercept's profile targeting both
vascular endothelial growth factor (
VEGF) and placental
growth factor seems to show favorable outcomes when compared to other purely anti-
VEGF treatment options. We therefore believe that
aflibercept is an excellent adjunctive
therapy in cases of adult-onset
Coats' disease with
macular edema. To our knowledge, this is the first case treated with
laser and intravitreal
aflibercept with a long three-year follow-up suggesting the significant role of
aflibercept in vascular permeability and supporting its use as a valuable therapeutic option for
Coats' disease.