成人Coats病1例

目的:报告成人Coats病1例,并探讨其引起的视网膜病变。方法:病例报告。结果:马来西亚63岁糖尿病患者1例,男,右眼无痛性视力下降1a,视力指数/2英尺,而左眼最佳矫正视力为6/12。右眼眼底表明颞侧后极部出现广泛的视网膜渗出物,可累及黄斑区和鼻侧视盘。异常分布的多区域血管位于黄斑颞侧且呈衰减趋势。眼底荧光血管造影显示,毛细血管扩张在视网膜渗出区域且有荧光素渗漏现象存在。左眼表现正常。根据临床和FFA结果,患者被诊断为成人Coats病,右眼行氩激光光凝治疗。激光后6mo,患者的视力保持在6/120并出现视网膜最小限度的回退。结论:临床和血管造影结果是视网膜毛细血管扩张症的重要诊断依据。渗漏区域激光光凝治疗有利于防止视力丧失。

Adult Coats' disease: a case report

·AIM: To present a case of Coats' disease in adult and to illustrate the retinal findings.·METHODS: A case report.·RESULTS: A 63 years old Malay man, a known case of diabetes mellitus, presented with one year history of painless and progressive reduced vision in the right eye. Right eye visual acuity was counting finger 2 feet while left eye best corrected visual acuity was 6/12. Right fundus showed presence of extensive subretinal exudates at the temporal part of the posterior pole involving the macular area and nasal to the optic disc. It was associated with multiple areas of abnormal blood vessels temporal to the macula with attenuated vessels. Fundus fluorescein angiography(FFA) showed presence of telangiectatic vessels at the area of subretinal exudates and leakage of fluorescein from the telangiectatic vessels. The left eye was normal. Based on clinical and FFA findings, he was diagnosed to have adult Coats' disease. The right eye was treated with argon laser photocoagulation. Six months post laser, his visual acuity remained at 6/120 and there was minimal regression of the disease seen in the retina. ·CONCLUSION: The clinical and angiographic findings are important in diagnosing retinal telangiectasia. Treatment by laser photocoagulation in area of leakages may be beneficial in preventing visual loss.