Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50028 Kaunas, Lithuania.
Medicina (Kaunas). 2012;48(4):224-7.
Coats' disease is an idiopathic disorder defined by an abnormal development of retinal vessels with a progressive deposition of intraretinal or subretinal exudates, leading to exudative retinal detachment. The most difficult task is to differentiate Coats' disease from retinoblastoma. We present a rare case of Coats' disease diagnosed in a 3-year-old girl. From the age of 6 months, the girl was followed up 2 times a year at the Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences, due to congenital convergent strabismus and refractive errors. At the age of 3.6 years, a routine examination of the fundus of the right eye revealed hard exudates, telangiectasia and tortuosity, gray color lesion below the optic nerve disc, submacular exudation in the inferior nasal part of the retina, and exudative retinal detachment, which extended from the 7-o'clock position to the 4-o'clock position. Before this examination, no abnormalities were found in the fundus of her both eyes. The girl was not treated with laser photocoagulation, cryocoagulation, or intravitreal injections, as the diagnosis of retinoblastoma could not be excluded; therefore, only eye drops were prescribed. In order to exclude the diagnosis of retinoblastoma, ultrasonography, magnetic resonance imaging, and computed tomography were carried out, and an appointment to see an ophthalmic oncologist was scheduled. Due to early and appropriate treatment, the progression of Coats' disease in patients could be arrested. However, in some cases, when the diagnosis is ambiguous, it is better to follow up the patient and to treat only with eye drops.
coats 病是一种特发性疾病，其特征是视网膜血管异常发育，伴有视网膜内或视网膜下渗出物的进行性沉积，导致渗出性视网膜脱离。最困难的任务是将 coats 病与视网膜母细胞瘤区分开来。我们报告了一例罕见的 coats 病病例，患者为 3 岁女孩。自 6 个月大以来，该女孩因先天性会聚性斜视和屈光不正，每年在立陶宛健康科学大学医院眼科接受 2 次随访。在 3.6 岁时，右眼眼底常规检查发现硬性渗出物、毛细血管扩张和扭曲、视神经盘下方的灰色病变、视网膜下鼻下部的黄斑下渗出物和渗出性视网膜脱离，从 7 点位置延伸至 4 点位置。在此检查之前，该女孩双眼眼底均未发现异常。由于不能排除视网膜母细胞瘤的诊断，该女孩未接受激光光凝、冷冻治疗或玻璃体内注射治疗，仅开具了眼药水。为了排除视网膜母细胞瘤的诊断，进行了超声、磁共振成像和计算机断层扫描，并安排了眼科肿瘤学家的预约。由于早期和适当的治疗，患者 coats 病的进展得以阻止。然而，在某些情况下，当诊断不明确时，最好对患者进行随访，仅使用眼药水治疗。
