Management of Coats Disease Microaneurysms With Fundus Fluorescein Angiography-Guided Navigated Laser

Purpose: The purpose of this case series is to test the safety and efficacy of navigated laser in the treatment of microaneurysms in Coats disease. Methods: In a multicenter, retrospective case series, 10 individuals with active, leaking Coats-related microaneurysms in the macula were included. All participants were treated with the Navilas navigated laser (OD-OS, GmbH, Teltow, Germany) in a navigated treatment mode guided by fundus fluorescein angiography with a minimum of 4-month follow-up. Primary outcomes included central retinal thickness, best-corrected visual acuity, and microaneurysm closure rate. Results: Mean age at navigated laser was 38.8 years (range, 14-61 years). Anatomic improvement or stabilization was noted in all participants (–10 µm), with stability within 10 letters of presenting visual acuity (±0.0 logarithm of the minimum angle of resolution [logMAR] [Snellen equivalent, 20/20]). No patient received any additional antivascular endothelial growth factor (anti-VEGF) treatment after the first navigated laser session. Patients could even discontinue previous anti-VEGF treatments. Conclusion: In this study, angiography-guided navigated laser treatment was a safe and effective treatment modality for Coats disease. The digital planning and navigated application of the laser seem to allow for good efficacy and a low complication rate.