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Emmanuel L. Bui Quoc, Geoffrey Dethorey, Emilie Costantini, Isabelle Ingster-Moati; Retinal Detachment In Coats’ Disease In Infants. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5812.
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Coats’ disease is a rare condition characterized by retinal telangiectasias and peripheral microaneurysms, responsible for under retinal exudation which can lead to major retinal detachment. Aim of our study: evaluation of the management of such retinal detachments.
Retrospective study of cases managed between 2006 and 2010.
Four cases were managed. The age at diagnosis varied between 16 an 32 months. Coats’ disease was unilateral in 3 cases and bilateral in one case. Follow up varied between 18 and 45 months. Among the unilateral cases, one eye was treated twice by laser photocoagulation, one eye required cryotherapy twice and one eye was treated only once surgically with cryotherapy. In the bilateral case, photocoagulation was performed twice one the better eye, while no therapy was performed on the other eye whose form of the disease was major. Retinal reattachment was obtained in the two unilateral cases twice, while the retina of the third case remained detached. Visual function was lost in the three cases. In the bilateral case, the retina of the treated eye remained attached, with preserved visual function. No neovascular glaucoma occurred.
Coats’ disease is a severe condition often diagnosed late in infants and responsible for the loss of visual function. Leukocoria or strabismus can be the initial signs of the disease. Retinoblastoma is the differential diagnosis to exclude. Late diagnosis is the cause of major retinal detachment whose treatment is uneasy and retinal reattachment is not always feasible. Visual function is often lost and the aim of management is to preserve the anatomical integrity of the eye. Laser photocoagulation of the telangiectasias or cryotherapy are the treatments required. Vitrectomy is hardly ever necessary or even advisable.
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