Rapid “epiretinal membrane” development following intravitreal bevacizumab for Coats' disease

PURPOSE: To report a case of rapid “epiretinal membrane” (“ERM”) development following intravitreal bevacizumab for juvenile Coats' disease. OBSERVATIONS: A 7-year old boy was followed for four years with asymptomatic stage 2 Coats' disease in his left eye. At age 11, he developed symptomatic cystoid macular edema. Argon laser photocoagulation to the leaking aneurysms failed to improve his vision, which had symptomatically declined to 20/30. Four-months after laser, a single injection of intravitreal bevacizumab was given. Rapid development of an “ERM” was noticed on his first post-injection follow-up at 4 weeks. By 8-weeks post-injection the visual acuity had deteriorated to 20/400. 25 + gauge pars plana vitrectomy with “ERM” peeling was performed, with recovery of vision to 20/30 at the 4 months post-operative visit. CONCLUSIONS AND IMPORTANCE: Intravitreal bevacizumab may induce rapidly progressive “ERM” in patients with juvenile Coats' disease.