Junker B, Hansen L L
Universitäts-Augenklinik Freiburg, Killianstr. 5, 79106 Freiburg.
Ophthalmologe. 2010 Apr;107(4):379-88; quiz 389-90. doi: 10.1007/s00347-010-2151-6.
Coats disease is characterized by idiopathic congenital retinal telangiectasis and exudative retinopathy. Mostly young males are affected. The disease is usually unilateral. Visual prognosis varies from full visual acuity to blindness according to the extent of retinal exudation. Retinoblastoma is a major differential diagnosis particularly in small children but other causes of exudative retinopathy must also be considered. Treatment aims include obliteration of the telangiectasis in order to resolve retinal exudation and achieve reattachment of the retina. Therapeutic options comprise laser coagulation or cryotherapy, drainage of subretinal fluid, buckling surgery and pars plana vitrectomy. In more advanced cases with therapy-resistant secondary glaucoma enucleation may be required. More recently, intravitreal administration of VEGF inhibitors has become an option.
科茨病的特征是特发性先天性视网膜毛细血管扩张和渗出性视网膜病变。主要累及年轻男性。该病通常为单侧性。根据视网膜渗出的程度,视力预后从完全视力到失明不等。视网膜母细胞瘤是主要的鉴别诊断疾病,尤其是在小儿患者中,但也必须考虑其他渗出性视网膜病变的病因。治疗目标包括闭塞毛细血管扩张,以消除视网膜渗出并实现视网膜复位。治疗选择包括激光凝固或冷冻疗法、视网膜下液引流、巩膜扣带手术和玻璃体切割术。在更晚期且伴有治疗抵抗性继发性青光眼的病例中,可能需要眼球摘除术。最近,玻璃体内注射血管内皮生长因子(VEGF)抑制剂已成为一种选择。