Its severe form (referred to as Coats disease) and milder form (sometimes termed Leber miliary aneurysms) that commonly present in adults, were initially described as separate entities. It has reportedly occurred in patients ranging from 4 months to 70 years of age, with the peak incidence in the first decade of life. Ĭoats disease commonly presents unilaterally with strong male predominance. The process is described as similar to pathogenesis of diabetic retinopathy, but definitely more severe and rapid. Exudation of lipids from the damaged vessels follows and is responsible for retinal detachment and cyst formation as well as retinal ischemia due to vessel closure. Alterations of endothelium of retinal vessels lead to breaking of blood-retinal barrier and presence of abnormal pericytes, causing formation of telangiectasias and closure of some vessels. The pathogenesis and progression of that disease depends on the impairment of retinal vasculature. Coats disease is an idiopathic condition characterized by telangiectatic and aneurysmal retinal vessels with intraretinal and subretinal exudation and fluid without appreciable retinal or vitreal traction, frequently associated with retinal detachment. Idiopathic peripheral retinal telangiectasia (IPT), usually referred to as Coats disease, has been well-described in the medical literature since its discovery in 1908. Close follow-up is necessary to achieve and maintain reasonable good visual and morphological results. The accompanying literature review suggests that ablative therapies, especially laser photocoagulation, remain the most effective treatment option in adult-onset IPT, with anti-VEGF therapy serving as an adjuvant procedure.
Yannuzzi retina atlas free download series#
Treatments applied in this series included observation, laser photocoagulation, and anti-vascular endothelial growth factor (VEGF) treatment with variable outcomes depending upon the extent of IPT, the aggressiveness of laser treatment, and the stringency of follow-up. Six cases of adult onset IPT were described with the following phenotypes based on fundus ophthalmoscopy, fluorescein angiography, and optical coherence tomography findings: IPT without exudates or foveal involvement, IPT with peripheral exudates without foveal involvement, IPT with peripheral exudates and cystoid macular edema, and IPT with peripheral and macular hard exudates.
The goal of this case series study and literature review was to describe and classify different presenting forms and treatment of this entity and to review contemporary methods of its management. Idiopathic peripheral retinal telangiectasia (IPT), often termed as Coats disease, can present in a milder form with the onset in adulthood.
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