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[Retinal exudative disease in childhood: Coats' disease and familial exudative vitreoretinopathy (FEVR)].
[coats disease]
This
article
reviews
the
pathophysiology
of
retinal
vascular
disease
with
emphasis
on
Coats
'
disease
and
familial
exudative
vitreoretinopathy
(
FEVR
)
.
Both
Coats
'
disease
and
FEVR
demonstrate
vascular
abnormalities
and
associated
exudation
.
Coats
'
disease
manifests
as
teleangiectasia
and
aneurysms
.
Exudative
subretinal
lipid
deposits
can
be
extensive
.
Coats
'
disease
is
in
90
%
unilateral
and
affects
predominantly
otherwise
healthy
young
males
.
If
the
retina
is
attached
,
laser
and
cryocoagulation
are
the
method
of
choice
.
Vitreoretinal
surgery
is
only
rarely
indicated
in
advanced
cases
after
a
retinoblastoma
has
been
excluded
prior
to
surgery
.
FEVR
inheritance
is
56
%
dominant
(
FZD
4
und
TSPAN
12
)
and
44
%
recessive
(
LRP
5
und
NDP
)
.
Temporal
dragging
of
the
vascular
arcades
and
heterotopia
of
the
macula
are
characteristic
for
FEVR
.
Subretinal
exudates
are
indicators
for
progression
of
the
disease
with
visual
loss
due
to
subsequent
exudative
or
tractive
retinal
detachment
.
Exudative
forms
require
treatment
and
reduction
of
peripheral
ischaemia
with
laser
photocoagulation
and
cryopexia
.
In
cases
of
tractive
detachments
vitreoretinal
surgery
is
necessary
.
Coats
'
disease
and
FEVR
are
both
progressive
diseases
requiring
lifelong
follow-up
and
therapy
.
Diseases
Validation
Diseases presenting
"vascular arcades"
symptom
coats disease
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