Intravitreal dexamethasone implant with retinal photocoagulation for adult-onset Coats' disease.

PURPOSE: To report a case of adult-onset Coats' disease with secondary retinal vasoproliferative tumor managed with dexamethasone intravitreal implant and retinal photocoagulation.

METHODS: Case study.

RESULTS: A 41-year-old female with counting finger vision was diagnosed with Coats' disease with secondary retinal vasoproliferative tumor in right eye. Fundus examination revealed exudative retinopathy involving posterior pole and a retinal tumor located in the inferotemporal quadrant. Optical coherence tomography scan confirmed massive exudative neurosensory detachment and fundus fluorescein angiography showed areas of telangiectatic vessels with capillary non-perfusion. Intravitreal injection of dexamethasone implant was done initially followed by laser photocoagulation when the detachment resolved. There was significant improvement in patient's visual acuity with no further recurrence of exudation.

CONCLUSION: Intravitreal dexamethasone implant Ozurdex(® ) (Allergan, Inc., Irvine, Calif., USA) may be an effective initial therapeutic approach for Coats' disease with massive exudation.