Clinical Characteristics and Treatment Outcomes in Unilateral Coats disease - a Global Collaborative Study.

Autor:	Tsai ASH; Singapore National Eye Centre, Singapore; DUKE NUS Medical School, Singapore., Wang CT; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan., Lee TC; The Vision Center, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA., Nagiel A; The Vision Center, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA; Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA., Matsunaga K; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Harper CA 3rd; Austin Retina Associates, Austin, Texas, USA; Department of Ophthalmology, Dell Medical School, Austin, Texas, USA., Wood EH; Austin Retina Associates, Austin, Texas, USA; Department of Ophthalmology, Dell Medical School, Austin, Texas, USA., Kim SJ; Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea., Hwang S; Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea., Shapiro MJ; Retina Consultants Ltd, Chicago, USA., Blair MP; Retina Consultants Ltd, Chicago, USA., Toth CA; Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, United States., Valikodath N; Kellogg Eye Center, Ann Arbor, Michigan, USA., Martinez-Castellanos MA; Association to Prevent Blindness, Hospital 'Luis Sanchez Bulnes,' National Autonomous University of Mexico, Mexico., Trese MGJ; Associated Retinal Consultants, Royal Oak, MI, USA., Capone A Jr; Associated Retinal Consultants, Royal Oak, MI, USA., Drenser K; Associated Retinal Consultants, Royal Oak, MI, USA., Tauqeer Z; Associated Retinal Consultants, Royal Oak, MI, USA., Besirli CG; Kellogg Eye Center, Ann Arbor, Michigan, USA., Eton E; Kellogg Eye Center, Ann Arbor, Michigan, USA., Hartnett ME; Byers Eye Institute at Stanford University, Palo Alto, CA, USA., Bair C; Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah, United States., Kennedy B; Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah, United States., Kusaka S; Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka Japan., Mano F; Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka Japan., Chang EY; Retina & Vitreous of Texas, Texas, USA., Rao P; Retina & Vitreous of Texas, Texas, USA., Hunt PJ; Department of Ophthalmology, Baylor College of Medicine., Walsh MK; Retina Associates Southwest and University of Arizona College of Medicine, Arizona, USA., Moore S; University of Texas Southwestern Medical Center, Dallas, Texas, USA., Sears JE; Cole Eye Institute, The Cleveland Clinic, Cleveland, OH, USA., Abraham J; Cole Eye Institute, The Cleveland Clinic, Cleveland, OH, USA., Schulgit M; Cole Eye Institute, The Cleveland Clinic, Cleveland, OH, USA., Vagaggini T; Retina Consultants of Minnesota, Edina, Minnesota., Quiram PA; Retina Consultants of Minnesota, Edina, Minnesota., Vavvas D; Massachusetts Eye and Ear, Boston, MA, USA., Patel NA; Massachusetts Eye and Ear, Boston, MA, USA., Hoyek S; Massachusetts Eye and Ear, Boston, MA, USA., Chan RVP; University of Illinois Chicago, Chicago, IL, USA., Challa N; University of Illinois Chicago, Chicago, IL, USA., Mendel T; Havener Eye Institute - Department of Ophthalmology & Visual Sciences, Ohio, USA., Dewan KS; Havener Eye Institute - Department of Ophthalmology & Visual Sciences, Ohio, USA., Rogers DL; Havener Eye Institute - Department of Ophthalmology & Visual Sciences, Ohio, USA., Amphornphruet A; Queen Sirikit National Institute of Child Health, Department of Ophthalmology, Bangkok, Thailand., Wu WC; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Jazyk:	angličtina
Zdroj:	Ophthalmology. Retina [Ophthalmol Retina] 2024 Nov 27. Date of Electronic Publication: 2024 Nov 27.
DOI:	10.1016/j.oret.2024.11.017
Abstrakt:	Purpose: To evaluate the clinical outcomes and prognostic factors in unilateral Coats disease in the era of anti-VEGF therapy. Design: Global, multicenter, retrospective case series. Subjects: 656 eyes of 656 subjects with Coats disease were included in this study. Exclusion criteria were Coats disease secondary to retinitis pigmentosa as well as bilateral cases. Methods: Clinical data from patients with Coats disease were collected from 20 ophthalmic practices around the world. We compared early-stage (stage 1-2) and advanced-stage (stage 3-5) Coats disease in terms of clinical characteristics and treatment modalities. Main Outcome Meaures: Functional outcomes include achieving visual acuity (VA) of 0.3 logMAR or better and VA improvement or stability. Anatomical failure was defined as the development of phthisis, chronic retinal detachment, massive fibrosis, or the requirement for enucleation. Results: Subjects with early-stage disease were significantly older, with a mean age of 17.4 ± 17.8 years, compared to 7.1 ± 7.1 years in the advanced-stage group (p < 0.001). There was a male predominance in both early and advanced stages (84.7%). Advanced disease was associated with a higher incidence of strabismus (20.2% vs. 6.7%, p < 0.001) and leukocoria (12.3% vs. 3.2%, p < 0.001). More subjects with early-stage disease received laser photocoagulation as monotherapy (44.7% vs. 21.1%, p < 0.001). Additionally, early-stage disease received more sessions of intravitreal anti-VEGF injections as adjunct therapy (4.4 ± 6.2 vs. 2.7 ± 2.1, p = 0.005). Factors associated with poorer functional outcomes included worse presenting visual acuity, advanced disease stage, and the presence of a foveal nodule. Worse presenting visual acuity and advanced disease stage was associated with lower likelihood of anatomical success while combination therapy increased the odds of anatomical success. Conclusion: Unilateral Coats disease predominantly affects males, regardless of disease stage. Identifying a foveal nodule is crucial for visual prognosis. Laser photocoagulation remains the primary treatment. While anti-VEGF may prevent enucleation, its role in early-stage disease requires further clarification. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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