Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Jakarta Eye Center Clinics and Hospitals, Jakarta, Indonesia.
J Med Case Rep. 2022 Jul 18;16(1):287. doi: 10.1186/s13256-022-03474-9.
This case report describes two rare cases of Coats disease in nonjuvenile patients with preserved vision.
Two otherwise healthy Asian males aged 15 and 29 years old presented with unilateral gradual blurred vision and scotoma, respectively. Visual acuity was 6/6 (0 logMAR) with no other abnormalities observed in the anterior segment of the eyes. Both posterior segment examinations and fluorescein angiography revealed retinal telangiectatic vessels, exudation, and hemorrhage. Additionally, optical coherence tomography of the first patient showed subfoveal fluid. Both patients were diagnosed with stage 2 Coats disease. Laser photocoagulation was performed on both patients. The first patient showed initial good response to therapy with resolution of the subfoveal fluid; however, he developed cataract and underwent cataract surgery after 3 years. In the second case, although the exudates and hemorrhage still persisted, the macula was spared and the patient did not have visual complaints. No adverse events were reported, and final visual acuity of both patients remained 6/6.
Coats disease in adolescence and adulthood may present with good vision. In mild and moderate cases of Coats disease, laser photocoagulation monotherapy may help preserve vision. Nevertheless, as recurrences and complications may still occur later in life, lifelong monitoring is recommended.
本病例报告描述了两例罕见的非青少年 Coats 病患者，他们的视力得以保留。
两名分别为 15 岁和 29 岁的亚裔健康男性，均以单侧进行性视力模糊和视野缺损就诊。视力均为 6/6（0 logMAR），眼前节未见其他异常。双眼后节检查和荧光素血管造影均显示视网膜毛细血管扩张、渗出和出血。此外，第一位患者的光学相干断层扫描显示黄斑下积液。两名患者均被诊断为 2 期 Coats 病。对两名患者均行激光光凝治疗。第一位患者对治疗有初步的良好反应，黄斑下积液消退；然而，他在 3 年后出现白内障并接受了白内障手术。第二位患者虽然渗出和出血仍然存在，但黄斑未受累，患者无视力障碍。未报告不良事件，两名患者的最终视力均保持在 6/6。
青少年和成人期的 Coats 病可能表现为良好的视力。在轻度和中度 Coats 病病例中，激光光凝单纯治疗可能有助于保留视力。然而，由于疾病仍可能在以后的生活中复发和出现并发症，建议进行终身监测。
