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3期科茨病的多疗法治疗:长期随访

Multiple Therapy Approach for Stage 3 Coats Disease: Long-Term Follow-Up.

作者信息

Mastropasqua Rodolfo, D'Aloisio Rossella, Stanga Paulo Eduardo, Haynes Richard

机构信息

Bristol Eye Hospital, Bristol, UK.

Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena 41121, Italy.

出版信息

J Ophthalmol. 2020 Oct 26;2020:8840630. doi: 10.1155/2020/8840630. eCollection 2020.

Abstract

PURPOSE

To assess long-term efficacy of a multiple therapy approach in the treatment and management of unilateral stage 3 Coats disease with exudative retinal detachment.

METHODS

2 eyes of 2 young patients suffering from unilateral stage 3 Coats disease underwent a multiple therapy approach consisting of surgical drainage of exudative subretinal fluid + one simultaneous and up to one subsequent intravitreal injection of bevacizumab + multiple (up to 3) laser photocoagulation sessions of retinal nonperfusion areas and leaking Coats vasculature.

RESULTS

Complete reabsorption of SRF and retinal reattachment were observed in both cases over the follow-up. In no cases, we observed progression to phthisis bulbi. No bevacizumab-related complications were observed. Epiretinal membrane onset was detected in one eye at the end of follow-up.

CONCLUSION

The management and treatment of this rare and degenerative disease in young subjects are still a challenge. The described technique is less invasive than conventional intraocular surgery and may be preferable to halt the devastating progression of the disease.

摘要

目的

评估多疗法治疗和管理伴有渗出性视网膜脱离的单侧3期科茨病的长期疗效。

方法

2例患有单侧3期科茨病的年轻患者的2只眼睛接受了多疗法,包括手术引流视网膜下渗出液+同时及后续最多1次玻璃体内注射贝伐单抗+对视网膜无灌注区和渗漏的科茨血管进行多次(最多3次)激光光凝治疗。

结果

随访期间,2例患者的视网膜下液均完全吸收,视网膜复位。所有病例均未进展为眼球痨。未观察到与贝伐单抗相关的并发症。随访结束时,1只眼睛检测到视网膜前膜形成。

结论

对年轻患者中这种罕见的退行性疾病的管理和治疗仍然是一项挑战。所描述的技术比传统的眼内手术侵入性小,可能更有利于阻止疾病的破坏性进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dde8/7609148/0a93a1da2c04/joph2020-8840630.001.jpg

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