Delhi Journal of Ophthalmology

Microincision vitrectomy for secondary epiretinal membrane in adult-onset Coats’ disease

Manmath Das1, Priyanka Chaudhary2, Abhishek Varshney3
1Consultant Retina Surgeon, K.I.M.S, KIIT Campus, Bhubaneshwar, Odisha, India
2Vitreoretina Services, Maharaja Agarsen Medical College, Agroha, Haryana, India
3Vitreoretina services, C.L. Gupta Eye Institute, Moradabad, Uttar Pradesh, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Abhishek Varshney MS
Consultant, Vitreoretina
C L Gupta Eye Institute, Ram Ganga Vihar
Phase 2 (Ext.), Moradabad (Uttar Pradesh)
PIN -244001, India
Email id: doctorabhishekvarshney@gmail.com


Received: 16-MAY-2020 Accepted: 16-AUG-2020 Published Online: 24-DEC-2019
DOI: https://dx.doi.org/10.7869/djo.480

Abstract
We report a case of a 20-year-old male who presented with a gradual painless decrease of vision in his left eye. Best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/200 in the left eye. Anterior segment examination was normal for both eyes. Left eye indirect ophthalmoscopy revealed the presence of a thick epiretinal membrane (ERM) along with telangiectatic vessels and subretinal lipid deposits in inferotemporal quadrant which became more obvious on Fluorescein angiography. Spectral-domain optical coherence tomography (SD-OCT) of left macula revealed a thick ERM with tangential contraction. The patient was diagnosed as adult-onset Coats’ disease (Stage 2A) with ERM. The patient underwent standard 25 gauge pars plana vitrectomy with ERM peeling followed by cryotherapy of the telangiectatic vessels. Postoperatively there was a decrease in the amount of subretinal lipid deposition with scarring and obliteration of telangiectatic vessels and BCVA improved to 20/20, N6 which remained stable throughout follow-up.

Keywords :Adult-onset Coats’ disease, Epiretinal Membrane (ERM), Pars plana Vitrectomy, Cryotherapy