解除白行者的诅咒—— coats 病的治疗。
Lifting the White Walker's curse-Management of Coats' disease.
机构信息
Department of Ophthalmology, National institute of Ophthalmology, Pune, Maharashtra, India.
出版信息
Indian J Ophthalmol. 2023 Aug;71(8):3117. doi: 10.4103/IJO.IJO_777_23.
BACKGROUND
Coats' disease, described by George Coats in the early 1900s, is an idiopathic unilateral retinal vascular abnormality with exudation occurring in young males. It is characterized by retinal telangiectasia with intraretinal or subretinal exudation. Coats' disease is mostly diagnosed in the first to the second decade of life, with a common presentation of leukocoria. Younger patients have a more severe presentation and are associated with poor visual prognosis. Management of Coats' disease varies from observation, cryotherapy with anti-VEGFs (Vascular Endothelial Growth Factor), and surgery to enucleation. The mode of treatment depends on the age of presentation, the severity of the disease, and the stage of the disease. Through this video, we describe the clinical features, pathology, and surgical management of a 2-year-old child with grade 3B of Coats' disease.
PURPOSE
To demonstrate successful surgical management of grade 3B of Coats' disease in a 2-year-old boy.
SYNOPSIS
Coats' disease mostly presents with a diagnostic dilemma due to its varied presentation. Early detection and treatment are the keys to salvaging the eye as well as the vision, hence, avoiding dreadful complications such as neovascular glaucoma or phthisis bulbi. We demonstrate successful surgical management of a child who presented with grade 3B of Coats' disease.
HIGHLIGHTS
Through this video, we aim to describe the clinical features, pathology, and surgical management of a 2-year-old child with grade 3B of Coats' disease. Combination of external drainage with vitrectomy, challenges faced, and the importance of visual rehabilitation postoperatively.
VIDEO LINK
背景
coats 病由乔治·科茨（george coats）于 20 世纪初描述，是一种特发性单侧视网膜血管异常，年轻男性易发生渗出。其特征是视网膜毛细血管扩张伴视网膜内或视网膜下渗出。 coats 病主要发生在生命的第一个到第二个十年，常见的表现是白瞳症。年轻患者的表现更为严重，与预后不良相关。 coats 病的治疗方法各异，包括观察、抗血管内皮生长因子（vascular endothelial growth factor，vegf）冷冻治疗和手术治疗（包括眼球摘除术）。治疗方式取决于发病年龄、疾病严重程度和疾病分期。通过本视频，我们将描述一例 2 岁患儿 3b 级 coats 病的临床表现、病理和手术治疗方法。
目的
展示 2 岁男孩 3b 级 coats 病的成功手术治疗。
概要
由于 coats 病的临床表现多样，因此该病的诊断存在一定的困难。早期发现和治疗是挽救视力和眼球的关键，从而避免出现新生血管性青光眼或眼球萎缩等严重并发症。我们展示了一例 3b 级 coats 病患儿的成功手术治疗方法。
要点
通过本视频，我们旨在描述一例 2 岁患儿 3b 级 coats 病的临床表现、病理和手术治疗方法。包括玻璃体切割术联合外部引流的治疗方法、手术中面临的挑战以及术后视觉康复的重要性。
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