Coats' disease


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retinopathy

 [ret″ĭ-nop´ah-the]
any noninflammatory disease of the retina.
central serous retinopathy a usually self-limiting condition marked by acute localized detachment of the neural retina or retinal pigment epithelium in the region of the macula, with hypermetropia.
circinate retinopathy a condition marked by a circle of white spots enclosing the macular area, leading to complete foveal blindness.
diabetic retinopathy retinal manifestations of diabetes mellitus, including microaneurysms and punctate exudates. There are two major forms of diabetic retinopathy, nonproliferative and proliferative. The nonproliferative form is characterized by dilation of the retinal veins and microaneurysms which may leak blood cells and/or plasma, causing internal hemorrhaging or edema in the retina. Edema in peripheral areas of the retina goes unnoticed by the patient and may go untreated, whereas edema occurring in the central retina (macula) causes noticeably decreased vision and is the primary cause of vision loss in nonproliferative disease. (See Atlas 4, Part D.) Treatment by local laser photocoagulation is aimed at sealing shut the breaks in the blood vessels and preventing additional leakage of fluid into the area. Early diagnosis and treatment are essential in this disease to enhance a final visual outcome of stabilization and prevention of further loss of vision.



In proliferative diabetic retinopathy new blood vessels form near the optic disk, break through the inner membranous lining, and grow on the vitreous chamber and elsewhere in the retina and may rupture, causing gross vitreous hemorrhage. Additionally, fibrous tissue is generated secondary to the new blood vessel formation, and both the fibrous tissue and the new blood vessels become firmly attached to the posterior vitreous face. As the vitreous humor moves, the blood vessels and fibrous tissue cause tractional pulling on the retina and may result in separation or detachment of areas of retina. Panretinal laser photocoagulation is the definitive therapy. The study of early treatment for diabetic retinopathy proved the efficacy of this procedure in causing regression of the new blood vessels and prevention of vitreous hemorrhage and tractional retinal detachments, the two major causes of vision loss from this form of the disease.
exudative retinopathy a condition marked by masses of white or yellowish exudate in the posterior part of the fundus oculi, with deposits of cholestrin and blood debris from retinal hemorrhage, and leading to destruction of the macula and blindness.
hemorrhagic retinopathy retinopathy marked by profuse hemorrhaging in the retina, occurring in diabetes, occlusion of the central vein, and hypertension.
hypertensive retinopathy that associated with essential hypertension; changes may include irregular narrowing of the retinal arterioles, hemorrhages in the nerve fiber layers and the outer plexiform layer, exudates and cotton-wool patches, arteriosclerotic changes, and, in malignant hypertension, papilledema. (See also Atlas 4, Part C.)
leukemic retinopathy a condition occurring in leukemia, with paleness of the fundus resulting from infiltration of the retina and choroid with leukocytes, and swelling of the disk with blurring of its margin.
retinopathy of prematurity a disease of the developing retinal vasculature of the premature newborn. The incidence correlates with degree of prematurity; that is, the more premature the infant is, the greater the possibility of this condition occurring. The cause is vasoconstriction of retinal capillaries due to the presence of very high concentrations of oxygen in these blood vessels, which produces an overgrowth of retinal blood vessels. The vascular proliferation and exudation of blood and serum detaches the retina and produces scarring and inevitable blindness. To prevent retinopathy of prematurity it is recommended that oxygen be administered to premature newborns in as low a concentration and for as short a time as feasible. Careful monitoring of the newborn and evaluation of oxygen tension level are essential because no totally safe dosage of oxygen that will prevent the retinal changes has been found. Called also retrolental fibroplasia.
proliferative retinopathy the proliferative type of diabetic retinopathy.

Coats' disease

Ophthalmology A usually unilateral AR condition, characterized by exudates and retinal detachment, affecting children from 18 months to 18 yrs of age; CD may be accompanied by hearing loss, muscle weakness, myopathic facies, mental retardation DiffDx Retinoblastoma
References in periodicals archive ?
Trese, "Optical coherence tomography angiography findings in Coats' disease," Ophthalmology, vol.
Baumal, "Optical coherence tomography angiography findings in Coats' disease," Ophthalmic Surgery, Lasers and Imaging Retina, vol.
Chen et al., "Vascular endothelial growth factor in Coats' disease," Acta Ophthalmologica, vol.
Increasing use of anti-VEGF agents has led to their application in Coats' disease as well.
Vitreoretinal surgery and scleral buckling are preferred for advanced Coats' disease (stage 3 and 4) patients with tractional bands or proliferative vitreoretinopathy (1,24,25,26) Additional internal or external subretinal fluid drainage also facilitates the application of laser photocoagulation or cryotherapy.
Other causes of exudative retinal detachment should be considered in the differential diagnosis of Coats' disease. Retinoblastoma, persistent hyperplastic primary vitreous, Norrie's disease, and familial exudative vitreoretinopathy in particular are more common in childhood and should definitely be considered.
Coats' disease is a chronic disease requiring long-term follow-up.
Intraoperative fluorescein angiography-guided treatment in children with early Coats' disease. Ophthalmology.
Intravitreal triamcinolone in Coats' disease. Ophthalmology, 2012;119:648-649.
The effect of intravitreal bevacizumab injection as the initial treatment for Coats' disease. Graefes Arch Clin Exp Ophthalmol.
(24.) Kranias G, Krebs TP Advanced Coats' disease successfully managed with vitreo-retinal surgery.