دورية أكاديمية
أعرض في EDS

Fovea-threatening and fovea-involving peripheral Coats disease: effects of posture and intervention.

التفاصيل البيبلوغرافية
العنوان: Fovea-threatening and fovea-involving peripheral Coats disease: effects of posture and intervention.
المؤلفون: de Souza EC; Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, São Paulo, 01246-903, Brazil. ecsoftalmo@gmail.com., Rosa E; Hospital de Olhos Sadalla Amin Ghanem, Joinville, Brazil., de Oliveira Dias JR; Universidade Federal de São Paulo, São Paulo, Brazil., Malerbi FK; Universidade Federal de São Paulo, São Paulo, Brazil., Leal BC; Faculdade de Medicina da Unit de Sergipe, Aracaju, Brazil., Junior HPP; Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, São Paulo, 01246-903, Brazil.
المصدر: International journal of retina and vitreous [Int J Retina Vitreous] 2022 Jun 17; Vol. 8 (1), pp. 42. Date of Electronic Publication: 2022 Jun 17.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101677897 Publication Model: Electronic Cited Medium: Print ISSN: 2056-9920 (Print) Linking ISSN: 20569920 NLM ISO Abbreviation: Int J Retina Vitreous Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2015]-
مستخلص: Background: We believe that our experience with patients presenting with Coats disease and macular sparing should be shared with our colleagues. We would like to show the effect of posture and prompt intervention in cases with fovea-threatening and/or fovea-involving peripheral Coats disease (FTPCD). This association has been poorly debated in our specialty and literature. We call the attention for the unexpexted scenario of observing the lost of the fovea during some types of traditional and prompt interventional treatments of these cases with previous 20/20 vision (something that we have been studying and observing for many years). In order to publish our best representative cases, we have chosen 8 Brazilian patients (age range, 7-62 years; 5 male) with FTPCD. All patients underwent multimodal imaging and different treatments (observation, sleep-posture repositioning, laser, intraocular steroids, and/or anti-vascular endothelial growth factor therapy). All patients, initially, informed to adopt a sleeping lateral-down position, favoring exudation shifting to the fovea pre-treatment. Most promptly-treated patients in this way (n = 4), developed subretinal fluid and exudates in the macula and some had irreversible central visual loss (n = 3). Patients with recent fovea-involving exudation who changed postural sleep position (to protect the foveal area) before and during treatment fared better, with some preserved central vision and an intact fovea (n = 5). The fundus status was correlated with the gravitational effects of posture before and after treatment. Despite prepared as an observational/interventional study, with a small number of cases, the most difficult part is documenting the sleep position of these patients and its influence in the outcomes as there is not good way to prove how well or poorly the positioning occurred in our cases. Finally, we also intended to call the attention to the fact that Coats disease must be studied in all its clinical stage variants and not only seen as a potential blinding and incurable ocular disease.
Case Presentation: This study is a retrospective and/or interventional analysis of eight cases with a less severe clinical variant of classic Coats disease that we refer to as fovea-threatening and fovea-involving peripheral Coats disease (FTPCD). All cases were unilateral with no systemic disease or family history of Coats disease. The bilateral anterior segment and intraocular pressure were normal in all patients. The characteristics of all patients are shown in the Table.
Conclusion: The funduscopic features of FTPCD are fundamental to disease understanding and optimal management. Habitual posturing may affect the fundus morphologic features of retinal exudation as observed in all current patients with exudative peripheral Coats disease. When sleep habitual posture is not observed in patients with FTPCD, the effects of prompt invasive treatments can cause rapid visual loss because of foveal subretinal pooling of exudates post-treatment. Initial vigilant adjusting of the habitual sleep posture for several patients with FTPCD, before the indication of traditional invasive treatments (laser and/or pharmacologic medications) can result in improved vision and fundoscopic morphologic features.
(© 2022. The Author(s).)
التعليقات: Erratum in: Int J Retina Vitreous. 2023 Mar 9;9(1):14. (PMID: 36894975)
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تواريخ الأحداث: Date Created: 20220617 Latest Revision: 20230309
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9205031
DOI: 10.1186/s40942-022-00382-4
PMID: 35715849
قاعدة البيانات: MEDLINE
الوصف
تدمد:2056-9920
DOI:10.1186/s40942-022-00382-4