Wojciech Hautz
The Children’s’ Memorial Health Institute, Poland
Title: Coats’ disease: Analysis of 68 patients (70 eyes)
Biography
Biography: Wojciech Hautz
Abstract
Coats’ disease is a rare, idiopatic illness caused by a presence of teleangiectatic – abnormal retinal vessels. Untreated may lead to retinal detachment, cataract and secondary glaucoma or even atrophy of the eye.
Aim of the Study: To determinate the most common diagnostic problems and evaluation of clinical response to the treatment of Coats’ disease in children.
Material and Methods: The examined group constituted 68 patients (70 eyes). All patients were Caucasian, the vast majority of them were boys (83, 8%) in 2, 9% disease was bilateral. Examinations allowing recognizing disease were indirect ophthalmoscopy and USG. The choice of treatment method depended on a clinical condition: Extensity and location of abnormal vessels. Cryotherapy, transpupillary laser hyperthermia and anty-VEGF injections were used. A mean time of observation was 41 months.
Results: The mean age, at which the patients were diagnosed, was 80 months. A hearing impairment was additionally noted in 4 patients (5, 9%). The most commonly observed first symptoms was decreased vision (42, 6%), squint (32, 4%) and leucocoria (14,7%). The most common improper diagnosis confirmed by local doctors was retinoblastoma. The biggest diagnostic problems were with patients with stage 3B (Shields’ classification)–complete retinal detachment. As a result of the conducted treatment the improvement of visual acuity was achieved in 39, 2% of eyes, stabilisation in 33, 3% and deterioration in 27, 5% of eyes. A statistically significant relationship was found between a baseline disease characteristics and a final anatomical effect and between the expanse of abnormal vessels area and a final anatomical effects. The best results were achieved in patients with early stages of the disease (1 and 2 Shields’ classification) and with a smaller expanse of abnormal vessels area (1-2 clock hours).