Presentation
Three cases are presented spanning the spectrum of primary retinal telangiectasia. [ncbi.nlm.nih.gov]
Presentation and Clinical Findings The most common presenting signs of Coats' disease are decreased visual acuity, strabismus and leukocoria. [reviewofophthalmology.com]
Presents a more streamlined format to the printed text to help you focus on the clinically actionable information you need everyday. [books.google.de]
Entire Body System
- Swelling
Most people do not require any treatment, however if a patient's vision is affected, laser treatment or injections of certain medicines into the eye can help in reducing macular swelling. [sydneyretina.com.au]
If the blood vessels begin to leak fluid and cause swelling and scarring, doctors may use laser treatments to help relieve the swelling and reduce complication. [verywell.com]
This forms tiny aneurysms, causing swelling and damaging macular cells. The disease almost always occurs in one eye, which differentiates it from Type 2. [aao.org]
This causes fluid build-up and swelling, impairing reflection of light and causing progressive vision loss. As damage continues, new blood vessels may form, which can break and leak. [rarediseases.info.nih.gov]
Blocking VEGF with medication injections reduces the growth of abnormal blood vessels, slows their leakage, helps to reduce swelling of the retina, and in some cases may improve vision. [sflhealthandwellness.com]
- Inflammation
Steroids are sometimes used to quell inflammation, and newer drugs, such as anti-VEGF (vascular endothelial growth factor) drugs, are being used to stop abnormal blood vessel growth. [verywell.com]
Pathophysiology Chronic neurodegenerative processes, vascular inflammation, occlusion and ectatic capillary changes lead to loss of outer retinal layers and formation of pseudolamellar macular holes with cysts or cavitations that can also be in inner [eyewiki.aao.org]
Gary An has over 10 years experience in the computational modeling of inflammation as it relates to sepsis, being the first researcher to publish on the use of agent-based modeling, a computer simulation method, in the area of acute inflammation and sepsis [docplayer.net]
Research output : Contribution to journal › Article Association of Age-related Macular Degeneration With Mortality in Patients With Acquired Immunodeficiency Syndrome; Role of Systemic Inflammation Jabs, D. A., Van Natta, M. L., Trang, G., Jones, N. [jhu.pure.elsevier.com]
COMPLICATIONS OF TREATMENT Complications of photocoagulation and cryotherapy for Coats’ disease include inflammation; hemorrhage; chorioretinal anastomosis formation; and retinal, chorioretinal, and subretinal fibrosis. [medtextfree.wordpress.com]
- Surgical Procedure
The majority of adverse events were related to the surgical procedure. In all cases these surgery-related events were resolved within 3 months. [prnewswire.com]
Retinal Perforations, Breaks Surgical Procedures and Postoperative Cases Toxic Retinopathies; see also Light Toxicitiy Trauma (Injury) Tumors, Neoplasma Vascular Diseases (see also: Systemic Immunologic Diseases) Sclera Strabismus, Ocular Motility Disorders [atlasophthalmology.net]
By the conclusion of the surgical procedure, all eyes had received a scleral buckle, the majority placed before the surgery (23, 60.5%), and the remaining eyes simultaneously with the vitrectomy procedure (15, 39.5%). [ncbi.nlm.nih.gov]
Cardiovascular
- Hypertension
[G. s., a running together, tumultuous concourse; (in med.) a concurrence of symptoms, fr. syn,… … Medical dictionary Complications of hypertension — Main complications of persistent high blood pressure Complications of hypertension are clinical outcomes [translate.academic.ru]
Hypertension, or high blood pressure, is widely known as a major contributing factor to heart disease. [cleanborder.eu]
Management Management should be aimed at controlling the hypertension. Accelerated hypertension is a medical emergency. Outcome Hypertensive retinopathy is associated with a two- to three-fold increase in the risk of stroke. [patient.info]
[…] and may have a genetic component, no specific genes responsible for MacTel type 2 have been identified. [3] [4] [5] Environmental factors may also play a role in the development of MacTel type 2. [5] Some researchers believe that people with diabetes, hypertension [rarediseases.info.nih.gov]
Anterior Chamber Brain and Optical Pathway Choroid Congenital Syndromes, Malformations and Abnomalities Conjunctiva Cornea Glaucomas, Ocular Hypertension Hypertensive Retinopathy Iris and Ciliary Body Lacrimal System Lens Lids Neuro-Ophthalmology Optic [atlasophthalmology.net]
Eyes
- Retinal Pigmentation
There have been only two reports of retinal pigmentation abnormalities and a single case of bilateral macular deposits in KMS, but this is the first report of a Coats type retinal telangiectasia. [ncbi.nlm.nih.gov]
H35.721 Serous detachment of retinal pigment epithelium, right eye H35.722 Serous detachment of retinal pigment epithelium, left eye H35.723 Serous detachment of retinal pigment epithelium, bilateral H35.729 Serous detachment of retinal pigment epithelium [icd10coded.com]
retinal pigment epithelium (Abbreviations & acronyms: pigmentary changes of the RPE ) (pl.) pigmentary mottling retinal pigment epithelium mottling (Abbreviations & acronyms: RPE-mottling, RPE mottling, mottling) Translation: Pigmentauflockerung des [zeitzfrankozeitz.de]
CONCLUSIONS: There have been only two reports of retinal pigmentation abnormalities and a single case of bilateral macular deposits in KMS, but this is the first report of a Coats type retinal telangiectasia. [ndcn.ox.ac.uk]
- Scotoma
[…] development of an absolute scotoma. [iovs.arvojournals.org]
February 17, 2014 Chief complaint : Decreased vision and a central scotoma in both eyes (OU) History of Present Illness : The patient is a 43-year-old male who presented with decreased vision and a central scotoma OU for the past 10 years, which has been [eyerounds.org]
History If asked, most patients with Mac Tel type 2 will complain of metamorphopsia or scotoma. With progression of the disease, an increased scotoma can be perceived with decreased visual acuity as this entity affects the fovea and perifoveal area. [eyewiki.aao.org]
Symptoms include blurred vision, metamorphopsia and paracentral scotomas. Fluorescein angiography will highlight the parafoveal telangiectatic vessels that show early hyperfluorescence with late leakage. [webeye.ophth.uiowa.edu]
Commmon complaints include blurry vision, distortion and scotomas. Imaging studies, including autofluorescence, fluorescein angiography and OCT can be helpful in making the diagnosis early, when findings may be subtle. [illinoisretina.com]
- Visual Impairment
Age-related macular degeneration (AMD) is the most common cause of visual impairment in people over age 60. Because it affects millions of senior adults, it deserves a great deal of attention. [lowvision.preventblindness.org]
They may be an incidental finding or may present with sudden painless visual loss from haemorrhage. More commonly there is gradual visual impairment due to insidious macular oedema and hard exudate formation (seen around the aneurysm on fundoscopy). [patient.info]
The extent of photoreceptor loss correlates with visual impairment, and limiting photoreceptor loss appears to be the most promising therapeutic approach to maintaining vision. [dovepress.com]
- Visual Impairment
Age-related macular degeneration (AMD) is the most common cause of visual impairment in people over age 60. Because it affects millions of senior adults, it deserves a great deal of attention. [lowvision.preventblindness.org]
They may be an incidental finding or may present with sudden painless visual loss from haemorrhage. More commonly there is gradual visual impairment due to insidious macular oedema and hard exudate formation (seen around the aneurysm on fundoscopy). [patient.info]
The extent of photoreceptor loss correlates with visual impairment, and limiting photoreceptor loss appears to be the most promising therapeutic approach to maintaining vision. [dovepress.com]
- Visual Acuity Decreased
Visual acuity decreases slowly and is often associated with hyperplasia of the retinal pigment epithelium (RPE). [eyerounds.org]
At 12 months, visual acuity had improved in one eye, remained stable in three eyes, and decreased in one eye. [nature.com]
Treatment
While no treatment has been proven to prevent progression, treatment may be helpful in some cases. [rarediseases.info.nih.gov]
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]
Therefore, no treatment was advised, and the patient remains with acuities of 20/100- in the right eye and 20/80- in the left. Initially, retinal signs can be subtle in type 2A IJRT, with no treatment being indicated. [ncbi.nlm.nih.gov]
Treatment There are several treatment modalities for Coats’ disease, depending on its stage; they are briefly summarized in table 2. [karger.com]
Prognosis
IJRT prognosis depends on type and clinical features. Long-term prognosis for central vision is poor. [journals.lww.com]
The presenting visual acuity also correlates with the long-term prognosis. [institut-vision.org]
Prognosis The primary factors determining final visual outcome in patients with Coats' disease are the presenting visual acuity, extent of retinal detachment and the extent of macular exudation. [reviewofophthalmology.com]
Whilst Macular Telangiectasia type 2 can lead to significant visual loss in some cases, overall the prognosis is favourable, with average visual acuities of 6/12 being reported. [maculaspecialists.com.au]
The ultimate prognosis for eyes with Coats’ diseases can be measured in terms of two end points: visual acuity and anatomical stability. [medtextfree.wordpress.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
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 The Mac Tel Project found a prevalence of diabetes mellitus (DM) of 28% and hypertension (HTN) of 52% in Mac Tel type 2. [eyewiki.aao.org]
Associations VATER syndrome The exact etiology is unknown and the disease is a non-hereditary disorder. [radiopaedia.org]
Epidemiology
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]
Table : Characteristics of the three types of idiopathic juxtafoveolar telangiectasia Types of IJFT* Epidemiology Signs and symptoms Treatment Prognosis IJFT type I Predominantly male. Mean age 40yo. [eyerounds.org]
In 1915 Leber wrote two more articles and concluded that the disease he had described in 1912 was a variant of Coats’ disease.[2] EPIDEMIOLOGY Coats’ disease is characterized by discrete zones of alteration in the retinal vascular structure with aneurysmal [medtextfree.wordpress.com]
Pathophysiology
Coats' disease, Leber's miliary aneurysms, and IMT may be part of a singular clinical spectrum sharing pathophysiologic and histopathologic features and similarities in clinical presentation. [ncbi.nlm.nih.gov]
Pathophysiology IMT pathophysiology is incompletely understood. 1-11 IMT is categorized into types (IMT-1 and IMT-2), with each type subcategorized by various stages connoting characteristics. 1-11 Each subtype and stage takes into account the entity’ [reviewdiseasehandbook.com]
Pathophysiology Chronic neurodegenerative processes, vascular inflammation, occlusion and ectatic capillary changes lead to loss of outer retinal layers and formation of pseudolamellar macular holes with cysts or cavitations that can also be in inner [eyewiki.aao.org]
Thus, it is possible that the pathophysiology, including the involvement of VEGF, in the 2 types of IMT may be considerably different. Intravitreal bevacizumab treatment may rapidly improve retinal oedema in other diseases. [nature.com]
This review will discuss the pathophysiology, clinical features, important diagnostic imaging studies, and available treatment options for MacTel. [dovepress.com]
Prevention
• To treat those cases with macular thickening that prevents a good laser spot. • To be able to repeat treatments. • In cases with glaucoma or repeated intravitreal triamcinolone injections, intravitreal Bevacizumab is a good option to prevent increase [evrs.eu]
While no treatment has been proven to prevent progression, treatment may be helpful in some cases. [rarediseases.info.nih.gov]
Watzke, MD, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Boulevard, Portland, OR 97239-4197; e-mail: [email protected] Supported in part by an unrestricted grant to Casey Eye Institute from Research to Prevent Blindness, [journals.lww.com]
Primary prevention No prevention has been shown to be beneficial, however most clinicians would recommend control of hypertension and diabetes mellitus if present as these two diseases have been shown to be more prevalent in mac tel. [eyewiki.aao.org]
The etiology of both types of MacTel is still unknown and no treatment has been found to be effective to prevent further progression. [en.wikipedia.org]