The management of "coats' response" in a patient with x-linked retinitis pigmentosa-a case report

Abstract

The management of exudative retinal detachment in Coats disease can be very difficult with variable results. A case is presented of a 12 year old boy who was diagnosed with X-linked retinitis pigmentosa with an associated "Coat's Response". The patient had a marked reduction in his left visual acuity due to intragel and subhyaloid haemorrhage as well as exudative retinal detachment. This was managed successfully with vitrectomy and endolaser, resulting in clearance of the haemorrhage and flattening of the retina. In our experience endolaser should be considered as viable therapeutic option in the management of this condition.

Figure 1

Optical coherence tomography scan of the left eye showing macular oedema.

Figure 2

Retinal photograph of the inferior retina of the left eye showing a bone spicule pattern of pigmentation and peripheral exudates.

Figure 3

Ultrasound B scan of the left eye showing a subhyaloid haemorrhage and overlying retinal detachment.

Figure 4

Retinal photograph of the left eye three months after surgery. The retina remains flat.