Coats'-like response in a patient with pars planitis.
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The clinical features of Coats' disease and congenital retinoschisis (RS) are distinctly different. Therefore, finding changes consistent with Coats' disease and congenital RS in a single eye is an unusual occurrence. The following report describes two cases with a Coats' telangiectatic lesion in one region of the retina separated by normal retina and the presence of central and peripheral congenital RS. Molecular genetic analysis of the Norrie disease and RS genes failed to identify disease-causing or polymorphic mutations in either of the genes, suggesting that the above condition is clinically and genetically a different disorder. Further studies are needed to identify the genes responsible for the above disorder and associated ocular manifestations.
PURPOSE: To report a rare case of Coats' disease in a 3-month-old male infant. METHOD: Interventional case report. We examined a male infant, born at 33 weeks of gestation, who did not receive ventilation with oxygen after birth. RESULT: In this patient, the left fundus showed telangiectasia and tortuosity at 3 months of age. His right eye showed no abnormality in the fundus. A month later, in addition to the presence of abnormal vessels, microaneurysms and exudation also appeared. The patient was diagnosed to have Coats' disease and both the abnormal vessels and microaneurysms in the temporal fundus were treated by laser photocoagulation. Six months later, the left fundus showed a resolution of the abnormal vessels and exudation. CONCLUSION: Most instances of Coats' disease occurring in an infant tend to already be severely advanced when diagnosed. Early and appropriate treatment of patients with Coats' disease makes it possible to stabilize and thus improve the outcome.
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We measured angiographically the foveal avascular zone (FAZ) in 26 subjects with idiopathic juxtafoveolar telangiectasia (IJFT) and 27 control subjects. Quantitatively, FAZ was significantly smaller in IJFT (median = 0 mm2) than in controls (median = 0.405 mm2). Qualitatively, the telangiectasia in IJFT was temporal (92.5% of eyes) and appeared as microaneurysms interconnected with several capillaries, spider-shaped microaneurysms, or Coats'-like telangiectasia. IJFT is characterized by temporal telangiectasia and small FAZ.
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A 9-year-old boy presented with an exudative retinal detachment, vascular telangiectasias, subretinal lipid, and retinal macrocyst formation. He underwent three sessions of large-spot diode laser for the treatment of Coats' disease. Serial examinations and fundus photography documented an excellent involutional response with an improvement in visual acuity.
We report a case of Coats' disease and lamellar macular hole in a 10-year-old boy who presented with blurring of vision in his left eye. This is the first reported case of Coats' disease presenting with a lamellar macular hole in a child.
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The use of B-can ultrasonography in ophthalmology is becoming increasingly important. There are several advantages of the Bronson-Turner system when compared with other B-scan instruments. The unit is quite compact and much less expensive. There is no need for a special laboratory and trained personnel, since it is operated easily by the ophthalmologist. Because a water bath is not necessary, uncooperative patients and children can be evluated. This instrument has been proven reliable and accurate in the diagnosis of retinal detachment, choroidal tumors, and intraocular foreign bodies, and is also capable of revealing more subtle abnormalities such as retinoschisis and vitreous membranes. The Bronson-Turner ultrasonoscope provides the clinician with a valuable instrument to evaluate ocular abnormalities in the presence of opaque media.
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PURPOSE: To report a case of a macular hole in a female adult with bilateral Coats disease. METHODS: The fundus photograph, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in two eyes, and observed theirs characters. RESULTS: Fundus photograph showed massive yellowish-white exudation in the temporal midperiphery of both eyes, but the degree was slighter in the right eye. There was 1/3 DD macular hole in left eye. FFA revealed general dilatation of capillaries, multiple aneurysms, and tortuous and closure of vessels in superotemporal midperiphery in both eyes, but the degree was slighter in the right eye. There was a one-third DD round transmitted fluorescence according the macula hole. ICGA revealed that hyperfluorescence of aneurysms in superotemporal midperiphery, the images of aneurysms were more clearly than in FFA. There was a 2/3 DD hypoflurescence of macula in the late phase of angiography. CONCLUSIONS: FFA and ICGA have respective advantage in revealing vascular abnormalities of Coats disease. Maybe there was some relationship between the abnormalities of retinal vascular and hypoperfusion of choroidial vascular in macula in this case.
Coats disease is an idiopathic disorder characterized by an abnormal development of retinal vessels (telangiectasia), with a progressive deposition of intraretinal or subretinal exudates, leading to exudative retinal detachment. Classically is isolated, unilateral and affects mainly boys between 4 to 8 years. The diagnostic methods include direct and indirect opthalmoscopy, fluorescein angiography, ultrasonography, CT scan, MR imaging, especially în the advanced stages of disease, when is difficult to differentiate from retinoblastoma. The treatment includes laser therapy of abnormal leaking retinal vessels and cryotherapy în early stages, more advanced stages require surgical techniques of retinal reattachment. Stabilization of the disease course or clinical improvement can be achieved using a carefully selected therapy.