科茨病:三级转诊中心的趋势和长期治疗结果。

IF 2.3 Q2 OPHTHALMOLOGY Therapeutic Advances in Ophthalmology Pub Date : 2021-12-05 eCollection Date: 2021-01-01 DOI:10.1177/25158414211055957
Avadhesh Oli, Divya Balakrishnan, Subhadra Jalali
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引用次数: 1

摘要

背景:coats病的长期治疗结果,特别是在抗血管内皮生长因子(VEGF)药物和仓库类固醇等新药物治疗的时代,人们对其了解甚少。目的:描述30年来在一家转诊中心评估的148只高士病的临床特征和治疗结果。材料和方法:我们对1987年6月1日至2017年7月31日诊断为Coats病的患者进行了回顾性图表回顾。收集了人口统计学、临床和治疗数据,并根据常规治疗(冷冻/激光)或辅助治疗(如玻璃体内类固醇或抗vegf)对长期功能和解剖结果进行了分析。结果:平均发病年龄15.22岁(中位11岁)。家族性渗出性玻璃体视网膜病变是最常见的转诊诊断,76/148(51.5%),其次是Coats病,37/148(25%),视网膜母细胞瘤,35/148(23.6%)。3B阶段在首发时最常见(31.8%),其次是2B(22.3%)和2A(16.9%)。共有107名患者接受常规治疗或联合佐剂治疗。平均随访时间为24.95个月。最终随访时,视力从基线logmar2.17 (Snellen-20/2958)改善至logmar1.88 (Snellen-20/1517) (p = 0.004)。当出现BCVA时,视力改善效果较好,p = 0.004。常规组与辅助组BCVA无统计学差异,p = 0.5。常规组和辅助组分别有78/99(78.8%)和45/49(91.8%)的解剖结果良好(p = 0.046)。结论:在这一系列超过30年的Coats病患者中,使用玻璃体内类固醇或抗vegf作为佐剂可获得更好的解剖结果。较好的基线视力、较低的病程和较年长的发病年龄被认为是导致良好视力结果的因素。摘要:在目前的148只Coats病眼系列中,与常规冷冻治疗或单独激光光凝相比,玻璃体内类固醇或抗vegf辅助治疗的效果更好。科茨病患者在基线、疾病早期和老年时表现出较好的视力,其最终视力效果较好。
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Coats' disease: trends and long-term treatment outcomes in a tertiary referral centre.

Background: The long-term treatment outcomes in Coat's disease - particularly in the era of newer pharmacotherapies such as anti-vascular endothelial growth factor (VEGF) agents and depot steroids - are poorly understood.

Aim: To describe the clinical features and treatment outcomes of 148 eyes with Coats' disease assessed in a referral centre over 30 years.

Materials and methods: We conducted a retrospective chart review of patients diagnosed with Coats' disease between 1 June 1987 and 31 July 2017. The demographic, clinical and treatment data were collected and long-term functional and anatomical outcomes were analysed based on the treatment either with conventional therapy (cryo/laser) or along with adjuvants like intravitreal steroids or anti-VEGFs.

Results: The mean age at presentation was 15.22 years (median 11). Familial exudative vitreoretinopathy was the most common referral diagnosis, 76/148 (51.5%), followed by Coats' disease, 37/148 (25%), and retinoblastoma, 35/148 (23.6%). Stage 3B was most common at presentation (31.8%), followed by 2B (22.3%) and 2A (16.9%). A total of 107 patients were treated either with conventional therapy or in combination with adjuvants. The mean follow-up period was 24.95 months. The visual acuity improved from baseline logMAR 2.17 (Snellen-20/2958) to logMAR 1.88 (Snellen-20/1517) at final follow-up (p = 0.004). The improvement in visual acuity was better when the presenting BCVA was <1 logMAR (Snellen 20/200), p = 0.004. No statistically significant change in BCVA was noted between conventional and adjuvant groups, p = 0.5. However, the final anatomical outcome was good in 78/99 (78.8%) in the conventional group and 45/49 (91.8%) in the adjuvant group, respectively (p = 0.046).

Conclusion: In this series of patients with Coats' disease over three decades, the use of intravitreal steroids or anti-VEGFs as adjuvants resulted in better anatomical outcomes. A better baseline visual acuity, lower stage of the disease, and older age at presentation were found to be the factors leading to favourable visual outcomes.

Summary: In the current series of 148 eyes with Coats' disease, adjuvant treatment with intravitreal steroids or anti-VEGFs resulted in better outcomes as compared with conventional cryotherapy or laser photocoagulation alone. Patients with Coats' disease who had presented with better visual acuity at baseline, lower stage of the disease and older age had better final visual outcomes.

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CiteScore
4.50
自引率
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发文量
44
审稿时长
12 weeks
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