Perez Marisa A, Shechtman Diana L, Gurwood Andrew
Nova Southeastern University College of Optometry, Southeastern University, 3200 S. University Drive, Ft. Lauderdale, Florida 33328, USA.
Optometry. 2011 Mar;82(3):158-65. doi: 10.1016/j.optm.2010.07.029. Epub 2010 Dec 13.
Primary retinal telangiectasia is characterized by abnormalities in the retinal vasculature. Any alteration of the normal retinal vasculature may result in variable degrees of retinal leakage, hemorrhages, and exudates. The retinal telangiectatic conditions of Coats' disease, Leber's miliary aneurysms, and idiopathic macular telangiectasia (IMT), although historically considered separate entities, may in fact be variants of the same pathophysiologic vascular process. This is based on observations noting that they share similarities in pathogenesis, histology, and clinical presentation. These observations are controversial and are contested in the literature. Conversely, others have documented Coats' disease, Leber's miliary aneurysms, and IMT as unique and separate retinal conditions, each with specific features.
Three cases are presented spanning the spectrum of primary retinal telangiectasia. Clinical evaluation, dilated fundus examination, and auxiliary testing document both the similar characteristics that the entities share as well as the distinct features, which define each disease's nomenclature and categorization.
Coats' disease, Leber's miliary aneurysms, and IMT may be part of a singular clinical spectrum sharing pathophysiologic and histopathologic features and similarities in clinical presentation.
原发性视网膜毛细血管扩张症的特征是视网膜血管系统异常。正常视网膜血管系统的任何改变都可能导致不同程度的视网膜渗漏、出血和渗出。尽管历史上认为科茨病、莱伯粟粒状动脉瘤和特发性黄斑毛细血管扩张症（IMT）的视网膜毛细血管扩张情况是不同的实体，但实际上它们可能是同一病理生理血管过程的变体。这是基于观察发现它们在发病机制、组织学和临床表现方面存在相似之处。这些观察结果存在争议，在文献中也受到质疑。相反，其他人将科茨病、莱伯粟粒状动脉瘤和IMT记录为独特且不同的视网膜疾病，每种疾病都有特定特征。
报告了3例涵盖原发性视网膜毛细血管扩张症范围的病例。临床评估、散瞳眼底检查和辅助检查记录了这些疾病共有的相似特征以及定义每种疾病命名和分类的独特特征。
科茨病、莱伯粟粒状动脉瘤和IMT可能是一个单一临床谱系的一部分，共享病理生理和组织病理特征以及临床表现上的相似之处。
