晚期Coats病的过程与治疗

来源 :国外医学.眼科学分册 | 被引量 : 0次 | 上传用户:tj_tong
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Coats病临床少见,患者多为青年,男性,常单眼受累。其特征为特发性视网膜毛细血管扩张和渗出性视网膜脱离,视网膜下脂蛋白的渗出与视网膜毛细血管扩张的程度成正比。如果视网膜毛细血管扩张不广泛且视网膜脱离很浅,应用光凝、冷凝或两者并用可使扩张的毛细血管闭塞,渗出性视网膜脱离减轻或消失。若有广泛的视网膜毛细血管扩张,并有球状渗出性视网膜全脱离,则无论冷凝或光凝均不能闭塞渗漏的血管,常可发展为继发性闭角型青光眼或新生血管性青光眼,最终需要摘除眼球。晚期Coats病,应用检眼镜和裂隙灯检查,颇似外生性视网膜母细胞瘤和白瞳症。很多晚期Coats病,由于不能除外视网膜母细胞瘤而被摘除眼球。如果Coats病能被确诊,即使患眼已经失明,为了美容也应尽力保存眼球。作者报告13例婴幼儿已经失明的晚期Coats病,均为单眼发病,具有球状渗出性视 Coats disease is rare clinical, mostly young patients, men, often monocular involvement. It is characterized by idiopathic retinal telangiectasis and exudative retinal detachment, exudation of subretinal lipoproteins is proportional to the degree of retinal telangiectasia. If retinal capillary dilatation is not extensive and the retinal detachment is shallow, the application of photocoagulation, condensation or both can make dilation of capillaries, exudative retinal detachment to reduce or disappear. If there is a wide range of retinal telangiectasia and spherical exudative retinal detachment, both condensed or photocoagulation can not occlude leaking blood vessels, often can develop into secondary angle-closure glaucoma or neovascular glaucoma, Ultimately need to remove the eye. Late Coats disease, the application of ophthalmoscopy and slit lamp examination, looks like exogenous retinoblastoma and pupil disease. Many advanced Coats disease, due to can not be excluded except retinoblastoma was removed the eye. If Coats disease can be diagnosed, even if the affected eyes have been blind, beauty should try their best to save the eye. The authors report 13 cases of infants and young children have been blind late Coats disease, are monocular disease, with spherical exudative
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