Abstract
BACKGROUND: To evaluate the efficacy and safety of intravitreal dexamethasone implant as an adjunctive treatment to ablative therapy in Coats' disease. METHODS: Consecutive Coats patients examined between February 2012 and January 2024 who received Dexamethasone implant with a follow-up for over twelve months were retrospectively evaluated. The demographic assessment, clinical staging, therapies, and clinical and anatomic outcomes were noted. RESULTS: Of 15 total patients, four were excluded due to short follow-up. Ten patients (90.9%) were male, and all had unilateral involvement, whereas the only female patient (9.1%) had bilateral disease at presentation. At admission, the mean age was 14.82 ± 17.27 years (range 2-60 years). Seven of 12 eyes (58.33%) had stage 3a1, three eyes (25%) had stage 3a2, and two eyes (16.67%) had stage 2b disease. The mean follow-up duration was 65.73 ± 41.81 months (range 18-131 months). At the last visit, visual acuity remained stable in six of 12 eyes (50%), deteriorated in two eyes (16.67%), and improved at least one Snellen line in four eyes (33.33%). Transient IOP elevation was noted in eight eyes (66.67%). Cataract progression was documented in seven (58.33%) eyes, and four had cataract surgery (33.33%). Cyberknife therapy and subsequent vitrectomy surgery were performed in one eye (8.33%) due to a secondary vasoproliferative tumor occurrence. No other dexamethasone implant-related complication was noted. CONCLUSIONS: Intravitreal dexamethasone implant can be a viable adjunctive option, especially in youngsters, to avoid frequent general anesthesia and in adults having massive macular exudation in addition to the conventional ablation treatments in Coats' patients. TRIAL REGISTRATION: Retrospectively registered. The study adhered to the principles outlined in the Declaration of Helsinki and was approved by the local ethics committee (Date: 12.02.2025, Number: 2025/05-24).