Zusammenfassung
Unter Morbus Coats versteht man eine Erkrankung, die durch idiopathische kongenitale retinale Teleangiektasien und eine dadurch bedingte exsudative Retinopathie charakterisiert ist. Sie betrifft hauptsächlich junge, männliche Patienten und ist fast immer unilateral. Je nach Ausprägungsgrad der exsudativen Komponente variiert die Visusprognose von vollem Visus bis zur vollständigen Erblindung. Differenzialdiagnostisch muss der Morbus Coats gerade bei Kleinkindern von einem Retinoblastom unterschieden werden, aber auch andere Ursachen für eine exsudative Retinopathie kommen in Frage. Die Behandlung zielt auf eine Verödung der Teleangiektasien, um eine Verringerung der Exsudation und eine Wiederanlage der Netzhaut zu erreichen. Als Therapieoptionen stehen Laser- oder Kryokoagulation, Ablassung der subretinalen Flüssigkeit, Buckelchirurgie und Pars-plana-Vitrektomie zur Verfügung. In fortgeschrittenen Fällen mit therapieresistentem Sekundärglaukom kann eine Enukleation des betroffenen Auges nötig werden. Neuerdings kann auch die intravitreale Gabe von VEGF-Inhibitoren erwogen werden.
Abstract
Coats disease is characterized by idiopathic congenital retinal telangiectasis and exudative retinopathy. Mostly young males are affected. The disease is usually unilateral. Visual prognosis varies from full visual acuity to blindness according to the extent of retinal exudation. Retinoblastoma is a major differential diagnosis particularly in small children but other causes of exudative retinopathy must also be considered. Treatment aims include obliteration of the telangiectasis in order to resolve retinal exudation and achieve reattachment of the retina. Therapeutic options comprise laser coagulation or cryotherapy, drainage of subretinal fluid, buckling surgery and pars plana vitrectomy. In more advanced cases with therapy-resistant secondary glaucoma enucleation may be required. More recently, intravitreal administration of VEGF inhibitors has become an option.
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Junker, B., Hansen, L. Morbus Coats. Ophthalmologe 107, 379–390 (2010). https://doi.org/10.1007/s00347-010-2151-6
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DOI: https://doi.org/10.1007/s00347-010-2151-6