LONG-TERM OUTCOMES OF TWO-PORT NONVITRECTOMY ENDOLASER THERAPY IN MODERATE-To-SEVERE STAGE 3A COATS DISEASE

Purpose: To report the long-term outcomes of two-port nonvitrectomy endolaser therapy (TPNVE) in moderate-to-severe stage 3A Coats disease. Methods: 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 anatomical success rate, number of treatment sessions, and complications were analyzed. Results: Of the 46 patients (47 eyes) included in the study, 33 eyes (70.2%) were stage 3A1, and the rest were stage 3A2. The mean (median, range) extent of exudative retinal detachment 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 anatomical 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 eyes (42.5%) 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. Conclusions: 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 exudative retinal detachment extent of at least four clock hours achieved anatomical success after a single TPNVE surgery.