Multiple Arterial Macroaneurysms in Acquired Coatsʼ Disease in an Adult – A Case Report

Strueven, V.; Schalenbourg, Ann; Wolfensberger, Thomas J.

doi:10.1055/s-0035-1545786

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…[3] Other recent case reports have also noted prominent macroaneurysms with hemorrhages in adult-onset Coats' disease. [10] In both of our cases, multiple arterial macroaneurysms were among the most prominent examination findings and were the primary culprit for the extensive exudation and hemorrhage seen.…”

Section: Discussionmentioning

confidence: 52%

Multimodal Imaging of Adult-onset Coats’ Disease

Bottini

Yuan

Singh

et al. 2019

AJOCT

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The majority of Coats’ disease cases are diagnosed in the first decade of life, though cases with symptom onset and first diagnosis in adulthood are well documented. While the cases diagnosed in childhood and adulthood share many of the characteristic features that define Coats’ disease, adult cases have been shown to present with less severe disease manifestations and an increased incidence of macroaneurysms with perianeurysmal hemorrhage. We present two cases of Coats’ disease diagnosed in adulthood that demonstrate prominent arteriolar macroaneurysms with perianeurysmal hemorrhages and contribute to an understanding of the adult Coats’ phenotype.

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Section: Discussionmentioning

confidence: 52%

Multimodal Imaging of Adult-onset Coats’ Disease

Bottini

Yuan

Singh

et al. 2019

AJOCT

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“…Так, аневризмы могут быть вторичными по отношению к ОВЦВС [2], диабетической ретинопатии [11], радиационной ретинопатии, идиопатическому ретиноваскулиту (артерииту) [12]. Ангиоматозные процессы -ретинит Коатса [3], болезнь Гиппеля -Линдау [13] и другие ретинальные капиллярные ангиомы -также могут напоминать РАМ. Кроме того, выраженную экссудацию, связанную с РАМ, можно интерпретировать как диабетический макулярный отёк или отёк, ассоциированный с ОВЦВС, а субретинальные и преретинальные кровоизлияния в макуле, типичные для РАМ, могут быть проявлением возрастной макулярной дегенерации.…”

Section: результатыunclassified

“…Ретинальная макроаневризма представляет собой локальное расширение сосуда сетчатки с потенциалом к местной функциональной декомпенсации сосудистой стенки, проявляющейся экссудативными и/или геморрагическими осложнениями [1]. Существует несколько состояний, связанных с формированием макроаневризм, включая окклюзии ветвей центральной вены сетчатки (ОВЦВС) и ретинит Коатса [2,3]. Однако наиболее часто макроаневризмы имеют идиопатический характер, возникая на фоне системной артериальной гипертензии [4].…”

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Optical coherence tomogrpaphy in differential diagnosis of retinal arteriolar macroaneurysms

Kulikov

Николаевич²,

Maltsev

et al. 2019

Ophthalmology Reports

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Aim. To study the prevalence and topographical distribution of retinal exudation in eyes with retinal arteriolar macroaneurysms (RAM) and in those with macular branch retinal vein occlusions (mBRVO). Methods. The prevalence of optical coherence tomography (OCT) signs (different types of retinal hemorrhages and accumulation of fluid as well as hard and soft exudates) was evaluated in 28 eyes with RAM (22 males, 6 females, mean age 66.0 ± 9.9 years) versus 17 eyes with mBRVO (9 males, 7 females, mean age 56.9 ± 10.5 years). Topographical distribution of retinal exudation on OCT retinal maps was evaluated in 7 RAM eyes (6 males, 1 female, mean age 66.0 ± 11.7 years) and 8 mBRVO eyes (5 males, 3 females, mean age 60.1 ± 19.2 years). The measures were 1) position of the point of the maximum retinal thickness in relation to the macular center and RAM, 2) difference between maximum retinal thickness in the macular center and that at the site of RAM localization (surrogate control point in mBRVO eyes). Results. Soft exudates and intraretinal fluid accumulation were mostly associated with mBRVO (p = 0.007 and p < 0.001, respectively), while hard exudates were found almost exclusively in RAM eyes (p < 0.001). Central retinal thickness in RAM eyes was lower than that of mBRVO eyes, 453.1 ± 148.6 μm and 797.5 ± 179.6 μm, respectively (p = 0.001). The point of maximum retinal thickness was found at the site of RAM localization in 8 out of 9 RAM cases (88.9%), and within the central subfield in 8 out of 8 mBRVO cases (100%). The difference between maximum retinal thickness in the macular center and at the site of RAM localization (surrogate control point in mBRVO eyes) was –77.9 ± 174.1 μm and 148.3 ± 100.4 μm for RAM and mBRVO eyes, respectively (p < 0.001). Conclusions. Evaluation of exudative signs and their topographic distribution based on OCT data may be used for differential diagnosis and laser treatment planning in RAM.

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Levels of cytokines in the aqueous humor guided treatment of refractory macular edema in adult-onset coats’ disease

Wang

Fan²,

Gao

et al. 2020

BMC Ophthalmol

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Background Two cases with refractory macular edema secondary to adult-onset Coats’ disease underwent unsatisfactory treatment by intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs and retinal photocoagulation. Case presentation The authors highlight the guiding effect of the measurement of cytokines in the aqueous humor for the treatment of adult-onset Coats’ disease with refractory macular edema. In the two cases, typical Coats’ disease changes, including telangiectasis, subretinal exudation and macular edema were observed. Initial treatment consisted of intravitreal anti-VEGF drugs and retinal laser photocoagulation; however, the response was poor. Then, the aqueous humor was acquired and the cytokine concentrations were measured (Flow Cytometry Analysis, Beijing Giantmed Medical Diagnostics Lab). When the cytokine levels were tested every time there would be quality control, with a fixed concentration of cytokines samples to detect before the results reported. A low level of VEGF and a high level of inflammatory cytokines were found. Then, treatment was switched to intravitreal injection of dexamethasone implant (Ozurdex®) (Allergan, Inc., Irvine, Calif., USA), which resulted in resolution of the refractory macular edema and improvement of visual acuity in both cases. Conclusions For refractory macular edema secondary to adult-onset Coats’ disease, measurement of the levels of VEGF and inflammatory cytokines can help clinic doctors precisely investigate the molecular mechanism of macular edema and thereby find a suitable treatment.

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Multiple Arterial Macroaneurysms in Acquired Coatsʼ Disease in an Adult – A Case Report

Cited by 3 publications

References 5 publications

Multimodal Imaging of Adult-onset Coats’ Disease

Multimodal Imaging of Adult-onset Coats’ Disease

Optical coherence tomogrpaphy in differential diagnosis of retinal arteriolar macroaneurysms

Levels of cytokines in the aqueous humor guided treatment of refractory macular edema in adult-onset coats’ disease

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