AIM:To describe the multimodal imaging features,treatment,and outcomes of patients diagnosed with adultonset Coats disease.METHODS:This retrospective study included patients first diagnosed with Coats disease at≥18 y...AIM:To describe the multimodal imaging features,treatment,and outcomes of patients diagnosed with adultonset Coats disease.METHODS:This retrospective study included patients first diagnosed with Coats disease at≥18 years of age between September 2017 and September 2021.Some patients received anti-vascular endothelial growth factor(VEGF)therapy(conbercept,0.5 mg)as the initial treatment,which was combined with laser photocoagulation as needed.All the patients underwent best corrected visual acuity(BCVA)and intraocular pressure examinations,fundus color photography,spontaneous fluorescence tests,fundus fluorescein angiography,optical coherence tomography(OCT),OCT angiography,and other examinations.BCVA alterations and multimodal image findings in the affected eyes following treatment were compared and the prognostic factors were analyzed.RESULTS:The study included 15 patients who were aged 24-72(57.33±12.61)y at presentation.Systemic hypertension was the most common associated systemic condition,occurring in 13(86.7%)patients.Baseline BCVA ranged from 2.0 to 5.0(4.0±1.1),which showed improvement following treatment(4.2±1.0).Multimodal imaging revealed retinal telangiectasis in 13 patients(86.7%),patchy hemorrhage in 5 patients(33.3%),and stage 2B disease(Shield’s staging criteria)in 11 patients(73.3%).OCT revealed that the baseline central macular thickness(CMT)ranged from 129 to 964μm(473.0±230.1μm),with 13 patients(86.7%)exhibiting a baseline CMT exceeding 250μm.Furthermore,8 patients(53.3%)presented with an epiretinal membrane at baseline or during follow-up.Hyper-reflective scars were observed on OCT in five patients(33.3%)with poor visual prognosis.Vision deteriorated in one patient who did not receive treatment.Final vision was stable in three patients who received laser treatment,whereas improvement was observed in one of two patients who received anti-VEGF therapy alone.In addition,8 of 9 patients(88.9%)who received laser treatment and conbercept exhibited stable or improved BCVA.CONCLUSION:Multimodal imaging can help diagnose adult-onset Coats disease.Anti-VEGF treatment combined with laser therapy can be an option for improving or maintaining BCVA and resolving macular edema.The final visual outcome depends on macular involvement and the disease stage.展开更多
Purpose:To report on surgical outcomes of removing subfoveal nodules and to evaluate the histopathological findings of subfoveal nodules in pediatric patients with coats’disease.Methods:This was a retrospective,inter...Purpose:To report on surgical outcomes of removing subfoveal nodules and to evaluate the histopathological findings of subfoveal nodules in pediatric patients with coats’disease.Methods:This was a retrospective,interventional case series in which 6 pediatric patients had large(>1 disk diameter)subfoveal nodules.Vitrectomy and excision of subfoveal nodules with silicon oil tamponade were performed.Silicon oil was removed 3 months later.Results:This study was carried out in 6 patients with a mean follow-up of 9.2±1.5 months(range:7-11 months),and the mean age was 5.2±2.4 years(range:2-8 years).Preoperative visual acuity ranged from light perception(LP)to 20/250,and postoperative visual acuity ranged from LP to 20/200.Histopathology revealed nodules composed of proliferating fibrous tissue,hyaline degeneration with foamy histiocytes,focal myofibroblast hyperplasia,ossified tissue,and cholesterol fissures,with chronic cellular infiltration.No nodules regressed during the follow-up period.Conclusion:Certain eyes of pediatric patients with coats’disease who underwent subfoveal nodule removal and no evidence of nodule regression may benefit from submacular surgery.Histopathological findings revealed that anti-proliferative and anti-fibrotic agents could be targets for treating coats disease.展开更多
文摘AIM:To describe the multimodal imaging features,treatment,and outcomes of patients diagnosed with adultonset Coats disease.METHODS:This retrospective study included patients first diagnosed with Coats disease at≥18 years of age between September 2017 and September 2021.Some patients received anti-vascular endothelial growth factor(VEGF)therapy(conbercept,0.5 mg)as the initial treatment,which was combined with laser photocoagulation as needed.All the patients underwent best corrected visual acuity(BCVA)and intraocular pressure examinations,fundus color photography,spontaneous fluorescence tests,fundus fluorescein angiography,optical coherence tomography(OCT),OCT angiography,and other examinations.BCVA alterations and multimodal image findings in the affected eyes following treatment were compared and the prognostic factors were analyzed.RESULTS:The study included 15 patients who were aged 24-72(57.33±12.61)y at presentation.Systemic hypertension was the most common associated systemic condition,occurring in 13(86.7%)patients.Baseline BCVA ranged from 2.0 to 5.0(4.0±1.1),which showed improvement following treatment(4.2±1.0).Multimodal imaging revealed retinal telangiectasis in 13 patients(86.7%),patchy hemorrhage in 5 patients(33.3%),and stage 2B disease(Shield’s staging criteria)in 11 patients(73.3%).OCT revealed that the baseline central macular thickness(CMT)ranged from 129 to 964μm(473.0±230.1μm),with 13 patients(86.7%)exhibiting a baseline CMT exceeding 250μm.Furthermore,8 patients(53.3%)presented with an epiretinal membrane at baseline or during follow-up.Hyper-reflective scars were observed on OCT in five patients(33.3%)with poor visual prognosis.Vision deteriorated in one patient who did not receive treatment.Final vision was stable in three patients who received laser treatment,whereas improvement was observed in one of two patients who received anti-VEGF therapy alone.In addition,8 of 9 patients(88.9%)who received laser treatment and conbercept exhibited stable or improved BCVA.CONCLUSION:Multimodal imaging can help diagnose adult-onset Coats disease.Anti-VEGF treatment combined with laser therapy can be an option for improving or maintaining BCVA and resolving macular edema.The final visual outcome depends on macular involvement and the disease stage.
基金supported by Natural Science Foundation of Sichuan Provincial Science and Technology Department(2023NSFSC1666).
文摘Purpose:To report on surgical outcomes of removing subfoveal nodules and to evaluate the histopathological findings of subfoveal nodules in pediatric patients with coats’disease.Methods:This was a retrospective,interventional case series in which 6 pediatric patients had large(>1 disk diameter)subfoveal nodules.Vitrectomy and excision of subfoveal nodules with silicon oil tamponade were performed.Silicon oil was removed 3 months later.Results:This study was carried out in 6 patients with a mean follow-up of 9.2±1.5 months(range:7-11 months),and the mean age was 5.2±2.4 years(range:2-8 years).Preoperative visual acuity ranged from light perception(LP)to 20/250,and postoperative visual acuity ranged from LP to 20/200.Histopathology revealed nodules composed of proliferating fibrous tissue,hyaline degeneration with foamy histiocytes,focal myofibroblast hyperplasia,ossified tissue,and cholesterol fissures,with chronic cellular infiltration.No nodules regressed during the follow-up period.Conclusion:Certain eyes of pediatric patients with coats’disease who underwent subfoveal nodule removal and no evidence of nodule regression may benefit from submacular surgery.Histopathological findings revealed that anti-proliferative and anti-fibrotic agents could be targets for treating coats disease.
