Long-Term Outcomes of Two-port Non-vitrectomy Endolaser Therapy in Moderate-to-severe Stage 3A Coats Disease.

Abstract

To report the long-term outcomes of two-port non-vitrectomy endolaser therapy (TPNVE) in moderate-to-severe stage 3A Coats disease. In this retrospective observational case series, patients with moderate-to-severe stage 3A Coats disease who were treated with TPNVE in a single tertiary referral vitreoretinal practice between March 2014 and May 2024 were included. The anatomic success rate, number of treatment sessions, and complications were analyzed. Of the 46 patients (47 eyes) included in the study, 33 (70.2%) eyes were stage 3A1, and the rest were stage 3A2. The mean (median, range) extent of ERD was 6.1 (5.0, 4.0-12.0) clock hours. The median (range) follow-up time was 67.7 (13.9-135.4) months. All 47 eyes achieved anatomic success with a median (range) treatment session of 2.0 (1-6) sessions. The median number of TPNVE treatments and conventional laser photocoagulation treatments was 1.2 (range, 1-2) and 0.0 (range, 0-4), respectively. Twenty (42.5%) eyes required only one session. There were 47 instances of recurrence in 27 eyes, of which over half (59.5%) took place in the first 6 months. Complications included cataracts in 11 (23.4%), vitreoretinal fibrosis in 11 (23.4%), subretinal fibrosis in 11 (23.4%), tractional retinal detachment in one (2.1%), and glaucoma in one (2.1%) of the eyes. TPNVE demonstrated efficacy in ablating abnormal vessels and reattaching the retina for moderate-to-severe stage 3A Coats disease. Approximately half of the eyes with an ERD extent of at least 4 clock hours achieved anatomical success after a single TPNVE surgery.