Kucukevcilioglu M, Sobaci G, Durukan A H, Erdurman F C, Ceylan O M
Gulhane Military Medical School, Department of Ophthalmology, Ankara, Turkey.
Nepal J Ophthalmol. 2014 Jan;6(11):109-12. doi: 10.3126/nepjoph.v6i1.10782.
To report an association between Coats and Eales diseases, an uncommon presentation.
A 21-year-old male presented with gradual visual impairment of two years duration in his left eye. The slit-lamp examination of the affected eye revealed +2 vitreous cells. The other findings were peri-papillary fluid accumulation and extensive macular lipid exudate deposition. Small white vessels were coursing over the macula. The major veins were dilated and tortuous and massive sheathing of both arteries and veins was forming a common sheath. In the mid-periphery and periphery of the retina, discrete hard exudates, tiny superficial retinal hemorrhages and massive vascular sheathing were present. In the inferotemporal region, two intra-retinal macrocysts were located distal to the retinal vasculature. Fluorescein angiography (FA) of the left eye highlighted numerous aneurysmal dilatations throughout the posterior pole. Fluorescein angiography also showed para-foveal telangiectasia and tiny telangiectatic vessels on the optic disk that led to late staining of the macula and optic disk. Hyperfluorescent patches of deep choroiditis were present in the early phases. There was segmental but no diffuse staining of the retinal veins which showed massive sheathing on fundoscopy. In the periphery, segmental venous staining and choroidal leakage to a lesser extent were observed. In the infero-temporal quadrant, a clear-cut zone of non-perfusion and vascular abnormalities (micro-macro aneurysms, veno-venous shunts, venous beading) at the junction between the perfused and non-perfused zones were present. The findings were reminiscent of both Coats and Eales diseases.
Though known as two distinct entities, both retinal pathologies may present in a single form.
报告科茨病和伊尔斯病之间的一种关联，这是一种不常见的表现形式。
一名21岁男性，左眼渐进性视力损害两年。患眼的裂隙灯检查显示玻璃体细胞为+2。其他发现包括视乳头周围积液和广泛的黄斑脂质渗出物沉积。小的白色血管横跨黄斑。主要静脉扩张迂曲，动静脉大量鞘膜形成共同鞘膜。在视网膜的中周部和周边部，可见散在的硬性渗出、微小的视网膜浅层出血和大量血管鞘膜。在颞下区域，视网膜血管系统远端有两个视网膜内大囊肿。左眼荧光素血管造影（FA）突出显示整个后极部有大量动脉瘤样扩张。荧光素血管造影还显示黄斑旁毛细血管扩张和视盘上微小的毛细血管扩张血管，导致黄斑和视盘晚期染色。早期可见深层脉络膜炎的高荧光斑。视网膜静脉有节段性但无弥漫性染色，眼底检查显示有大量鞘膜。在周边部，可见节段性静脉染色和程度较轻的脉络膜渗漏。在颞下象限，在灌注区和非灌注区交界处有一个明确的无灌注区和血管异常（微动脉瘤、静脉-静脉分流、静脉串珠样改变）。这些发现使人联想到科茨病和伊尔斯病。
虽然这两种视网膜病变被认为是两种不同的疾病，但它们可能以单一形式出现。
