Objective To evaluate the effects of retinal cryotherapy and intravitreal triamcinolone injection to treat Coatsprime; disease with exudative retinal detachment.Methods This was a prospective consecutive case study, and 21 patients (21 eyes) with Coatsprime; disease accompanied by exudative retinal detachment were enrolled. There were 19 males and two females patients, aged from two to 18 years. Fifteen eyes had partial retinal detachment (stage 3A) and six eyes had total retinal detachment (stage 3B). All patients underwent cryocoagulation and intravitreal triamcinolone injection. Three eyes underwent sclerotomy to drain subretinal fluid. Four eyes underwent further treatment by photocoagulation or cryotherapy for the residual abnormal blood vessels after the surgery. The follow-up ranged from three to 15 months with an average of seven months. Visual acuity, intraocular pressure, eye position and eye movements, slit lamp microscope, indirect ophthalmoscope and color fundus imaging were followed up. The last followup time was considered as the judgment time for the therapeutic effects. Results Six eyes had increased intraocular pressure after the surgery, which was controlled by local drug treatment. At the end of follow-up, 19 eyes had reattached retina, one eye had partial retinal detachment and one eye had total retinal detachment. The vision improved in three eyes,unchanged in 14 eyes, and decreased in two eyes. Other complications included strabismus (one eye) and cataract (four eyes). Conclusion The combined treatment of cryotherapy and intravitreal triamcinolone injection is an effective therapy for the Coatsprime; disease with exudative retinal detachment, as retina reattaches and visual function is saved in most patients after this treatment.
Objective To observe the clinical manifestation and treatment effect of Coatsprime; disease in adulthood. Methods The clinical data of 18 adult patients with Coatsprime; disease from 1980 to 2006 at the department of ophthalmology, Peking Union Medical College Hospital which had been diagnosed by ocular fundus examination and fundus fluorescein angiography (FFA), were retrospectively analyzed. The follow-up period was one year. Coatsprime; response diseases in all the patiens were excluded, such as history of radiation therapy, intraocular inflammation, retinal vascular occlusion, age-related macular degeneration (AMD) and more leakage of diabetic retinopathy. The patients, 14 males and 4 females, 11 left eyes and 7 right eyes, all of them occurs in unilateral; aged from 37 to 55 years with the average age of 43 years; the initial diagnostic vision was 0.02 to 1.5, the visual value was 0.1. 17 patients (17 eyes) were treated by laser photocoagulation, 1 patient was treated by release of retinal operation with condensation. The mean follow up period was 3.7 years (ranged from 1 to 15.3 years). Results In 18 patients (18 eyes), vitreous clear in 14 eyes, vitreous few muddy in 4 years when initial diagnosis. The optic discs in 18 eyes are normal. Lesions confined to one or two quadrant, for the most are in the temporal(15/18 eyes), less are in Bice (4/18 eyes), only one eye at top; two eyes lesions involved in 2 quadrant. There are typical retinal vascular anomalies expansion, miliary aneurysm, arterial aneurysm, macroaneurysms and capillary without perfusion areas; yellowwhite hard leakage by a large block or cluster in Lesion corresponding region. More than half of the eyes with macular edema or leakage; limited retinal detachment in 4 eyes, the range was very wide in 1 eye; retinal hemorrhage in 3 eyes. After treatment the exudation or the hemorrhage were absorbed and retinas were reset. Compared the visual acuity with before treatment, mostly (64.3%) improved 2 lines or keep in 1.2-1.5, no one decreased over 2 lines. The last vision was 0.02-1.5, the visual value was 0.1. Conclusions Coatsprime; disease in adulthood diagnosed in first time has similar characteristics with children, such as vascular anomaly of retina, fundus exudation. The differences including limited area of involvement, less hemorrhages, mild damage on macular, slow development of lesions in follow-up period and better visual prognosis. （Chin J Ocul Fundus Dis，2008，24：279-282）
Objective To analyze and summarize the clinical regulation and ocular fundus characteristics of the Coats diseases paients. Methods The clinical data of 205 Coats diseases (211 eyes) which including sex, age, which-eye and visual distribution were retrospectively analyzed. To analyze the region,scope, and degree of the disease according to the ophthalmoscopy, ocular fundus photography, and fundus fluorescein angiography results, in additon to invistigate the distribution and development rule of lesions. Results In 205 cases, Coats disease was diagnosed at a median age of 28 years old. There were 54.2% patients over 20 years old. It occurred in 76.1% males，and was unilateral in 97.1% patients. In 211 eyes, the visual acuity was below 0.3 in 67.3% eyes. The retinal telangiectasia occurred in all eyes, with yellow white lipid exudation in 90.5% eyes; located in temporal fundus in 90.1% eyes, in front of midperipheral 73.9% eyes; spread over one sector in 72.5% eyes. Conclusions Coats disease occurs mostly in males; it can occurrs in any age; it almost occurrs in unilateral. The essential characteritics are abnormal expansion of microvascular, mostly located in temporal fundus and in front of midperipheral, with yellow white lipid exudation, spread macular and damage visual function seriously. （Chin J Ocul Fundus Dis，2008，24：276-278）
ObjectiveTo evaluate the surgical effects for Coats′ disease.MethodsA total of 16 patients (17 eyes) with Coats′ disease accompanied by exudative retinal detachment underwent cryocoagulation therapy and vitrectomy. The post-operative follow-up lasted 4.25-62.25 months (mean 13.10 months). ResultsAfter the operation, retina reattached completely in 8 eyes (without silicon oil tamponade) with the reattachment rate of 47%, reattached with silicone tamponade in 1 eye, and didn′t completely reattached in 8 eyes. The post-operative vision improved in 5 eyes, remained still in 2 eyes，and decreased in 7 eyes. The operative complications included transitory exacerbation of exudative retinal detachment, focal preretinal proliferation, cataract, secondary glaucoma and vitreous hemorrhage.ConclusionMost of the patients with Coats′ disease accompanied by exudative retinal detachment may have reattached retina after the surgery, and some patients have improved visual acuity.(Chin J Ocul Fundus Dis, 2005,21:145-147)
Objective To analyze the problems in the diagnosis of Coats disease and its main causes of misdiagnosis. Methods The clinical data of a group of patients with Coats diseases who had undergone indirect ophthalmoscopy, ocular fundus photography, fundus fluorescein angiography (FFA) and follow-up examination were retrospectively analyzed. The main causes of misdiagnosis were analyzed via reviewing the images of FFA and revising or confirming the initial diagnosis of Coats diseases according to the main features of abnormal dilation of retinal capillary vessels. Result In 68 patients (75 eyes), there were 45 cases whose initial diagnosis was Coats disease while the final diagnosis was not, in whom the final diagnosis was old retinal vein occlusion in 21, retinal vasculitis in 9, diabetic retinopathy in 3, old posterior uveitis in 3, congenital retinoschisis in 3, and proliferative vitreoretinopathy, familial exudative vitreoretinopathy, racemose hemangioma, old rhegmatogenous retinal detachment, macular epiretinal membrane, and idiopathic juxtafoveal telangiectasis in 1, respectively. There were 23 patients who was diagnosed as Coats disease in the final diagnosis but not the initial one. The initial diagnosis was old posterior uveitis in 6 patients, retinal vasculitis in 5, exudative age-related macular degeneration in 4, retinal main arterial tumor in 2, retinal angioma in 3, intraocular tumor in 2, and central serous chorioretinopathy in 1. Conclusions There are many problems in the clinical diagnosis of Coats disease. The main reason of misdiagnosis is that the clinicians can not comprehensively master the core of the definition of Coats disease and its clinical characters. (Chin J Ocul Fundus Dis, 2005, 21: 377-380)
PURPOSE:Toinvestigate the classification and the age incidence of Coats disease. METHODS:75 cases(79 eyes)of Coats disease were analysed,which were diagnosed by fundus fluorescein angiograpy(FFA)between Jan.1981 and Dec.1994. RESULTS:The patients included 59 males and 16 famales.Average age of the first presentation was 26 years old,and there were 45(60%)cases aged from 19 to 60 years old.In 5 eyes,the ophthalmoscopic examination revealed no obviously abnormal retinal blood vessel,but a number of dilated retinal vessels and microaneuryms were demonstrated by FFA. CONCLUSIONS:The autors consider that there is no essential distinction between type Ⅰand type ⅡCoats disease and it is no longer suitable to apply the traditional classification.Coats disease affects not only juvenile patients but also persons of all ages. （Chin J Ocul Fundus Dis,1996,12: 77-79）