Presentation
Adult onset coats disease in a 56-year-old male: An atypical presentation. Med J DY Patil Univ 2015;8:350-3 How to cite this URL: Dhawan B, Goel A, Singh R, Vig V. Adult onset coats disease in a 56-year-old male: An atypical presentation. [mjdrdypu.org]
Cases presenting with leucocoria or strabismus presented early whereas subjective visual loss presented much later. A large proportion of eyes (44%) were blind at diagnosis. [nature.com]
All eyes presented with profound visual loss with uniocular presentation and exudative retinal detachments at the late stages, with poor visual prognosis. [journalajmah.com]
Retinal exudation was present in 1, 2, 3 and 4 quadrants in 5 eyes (22.7%), 7 (31.8%), 3 (13.6%), and 7 (31.8%) respectively. Foveal exudation was present in 18 eyes (81.8%). [iovs.arvojournals.org]
Patient age, sex, date of presentation, date of last follow-up, number of laser and bevacizumab application sessions, presenting stage of Coats’ disease, and final stage of Coats’ disease were recorded. [dovepress.com]
Entire Body System
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Asymptomatic
Symptoms of Coats' disease The disease is asymptomatic in early stages. The most common symptom is called leukocoria (abnormal white reflection of the retina). [gotzaridis.gr]
Very mild cases can be totally asymptomatic. Severe leakage can cause extensive vision loss from lipid and fluid damaging the macula or from retinal detachment. Coats’ disease predominantly occurs in males and only affects one eye. [eyecenters.com]
In children younger than 4 years old leukocoria or strabismus are the main manifestations, but older children could be asymptomatic so we need to be particularly vigilant with these patients,” she told delegates attending the World Society of Paediatric [eurotimes.org]
Early stages of the disease are generally asymptomatic and evolution is variable. [orpha.net]
Clinical presentationClinical presentation Most patients • Leukocoria – Commonly • Strabismus • Decreased vision In older children, • Asymptomatic • Discovered during routine eye check up. 16. [slideshare.net]
Workup
Microbiology
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Toxocara Canis
Toxocariasis is an infection by the nematode larvae of Toxocara canis. [diagnosticpathology.biomedcentral.com]
Treatment
In these patients, treatment should be considered in case of documented progression. Argon laser photocoagulation is the treatment of choice in the early stages. [institut-vision.org]
Historically, treatment was based on clinical findings. However, with the advent of wide-field imaging, the first step which guides treatment is now wide-angle fluorescein angiography to identify areas of leakage and capillary dropout. [morancore.utah.edu]
The pre-treatment VEGF concentration in aqueous humour was 908 pg/ml and reduced to 167 pg/mL after the treatment. [ghrnet.org]
There are treatments that can be offered. What are the treatments for Coats’ disease? The child may be offered laser treatment. The laser is targeted at the abnormal blood vessels, at the point where they are leaking, which causes them to seal up. [gosh.nhs.uk]
Parlak and Saatci reviewed the use of bevacizumab, ranibizumab, and pegaptanib as an adjuvant treatment with subsequent necessary treatments as mentioned above [10]. There were no reports on the use of aflibercept in children with Coats disease. [cureus.com]
Prognosis
The presenting visual acuity also correlates with the long-term prognosis. [institut-vision.org]
The prognosis varies in each case. Factors that effect the prognosis include the stage of disease at the time of diagnosis, the age at diagnosis, the rate of disease progression, and the effectiveness of treatment. [rarediseases.info.nih.gov]
Stage 1 : (Telangiectesia with minimal/no exudation) • Observation • Laser photocoagulation Prognosis Eye can be saved Visual prognosis is favorable 46. [slideshare.net]
The key to better prognosis is earlier detection, which yields earlier treatment intervention. [jmedscindmc.com]
Prognosis The prognosis depends on the extent of the disease with milder, older presenting cases, having a better prognosis, of even spontaneous regression, whereas children under the age of three have a poorer prognosis. [eyewiki.aao.org]
Etiology
Etiology and pathogenesis The etiology remains poorly understood. Recent data indicate the causative role of somatic mutation in the NDP gene. [institut-vision.org]
Etiology An abnormal permeability of capillary endothelial cells in the retina, along with abnormal pericytes, causes the retinal vascular leakage that is the hallmark of CD. [orpha.net]
Coats disease is a telangiectatic neovascular disease of the retina of unknown etiology that frequently affects unilateral eyes of young males. [eyewiki.aao.org]
Subsequent investigations and the failure of anti-inflammatory adrenocorticotropic hormone and steroid therapies have refuted early theories of a primary infectious or inflammatory etiology. 13, 14 Pathologic samples of eyes with Coats disease were once [clinicalgate.com]
Associations VATER syndrome The exact etiology is unknown and the disease is a non-hereditary disorder. [radiopaedia.org]
Epidemiology
Epidemiology: This rare disorder manifests itself in young children andteenagers. Boys are usually affected (in about 90% of all cases). Coats’ disease usually occurs in young and teenage boys. It is nearly always unilateral. [brainkart.com]
Summary Epidemiology Annual incidence is Clinical description CD onset predominantly occurs in male children between 6 and 8 years old. Early stages of the disease are generally asymptomatic and evolution is variable. [orpha.net]
A population-based study of Coats disease in the United Kingdom I: epidemiology and clinical features at diagnosis. [nature.com]
Epidemiology Coats disease is a very rare eye disorder. The exact prevalence is unknown. There is a clear male predominance (more than 75% of patients) and no ethnic predisposition. [institut-vision.org]
"A Population-Based Study of Coats Disease in the United Kingdom I: Epidemiology and Clinical Features at Diagnosis." Eye 24 Dec. 2010: 1797-1801. Shields, J.A., et al. "Classification and management of Coats disease: the 2000 Proctor Lecture." [medicinenet.com]
Pathophysiology
Our understanding of the underlying pathophysiology continues to improve, as do our diagnostic and treatment modalities. Intravitreal therapy represents an exciting addition to traditional ablative techniques. [reviewofophthalmology.com]
Stable cases may be observed. 3, 7 However, Coats’ disease has been reported to recur even 10 years after initial diagnosis so life-long observation is recommended. 8 Pathophysiology: The exact mechanism remains elusive, but there is some evidence that [morancore.utah.edu]
Prevention
This prevents the normal flow of blood, and allows fluid to leak out of the blood vessels causing a buildup of fatty (lipid) material into the retina. [aapos.org]
In very occasional cases, treatment can improve vision, but in most cases the aim of treatment is to prevent further worsening of vision. [rnib.org.uk]
Treatment is effective in preventing blindness in about 50% of all patients. Study Material, Lecturing Notes, Assignment, Reference, Wiki description explanation, brief detail [brainkart.com]
Luckily, if it's detected early enough, it can be prevented. Doctors say the main problem with Coats' is that its symptoms are hard to spot, even for the individual suffering from the disease. [businessinsider.com]