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[Long-term prognosis of 5 cases with stage 3A Coats disease after vitrectomy].
[coats disease]
The
effectiveness
of
laser
photocoagulation
and
/
or
cryopexy
to
the
abnormal
retinal
vessels
for
the
treatment
of
eyes
with
Coats
disease
is
reported
.
However
,
in
Coats
cases
with
serous
detachment
laser
photocoagulation
and
/
or
cryopexy
is
sometimes
not
enough
to
coagulate
and
consecutively
scar
the
abnormal
vessels
,
leading
to
persistent
subretinal
fluid
and
multiple
courses
of
treatment
.
Therefore
,
we
investigated
the
long
-term
prognosis
of
Stage
3
A
Coats
cases
with
macular
detachment
which
underwent
vitrectomy
.
Five
eyes
of
5
cases
(
all
men
)
with
Stage
3
A
Coats
disease
,
which
underwent
primary
vitrectomy
between
1999
and
2009
,
were
investigated
retrospectively
.
The
average
age
at
vitrectomy
was
13
.
8
years
(
range
;
6
-
21
years
)
and
the
average
preoperative
visual
acuity
in
decimal
equivalent
was
0
.
1
(
range
;
0
.
04
-
0
.
5
)
.
The
average
follow-up
period
after
vitrectomy
was
83
months
(
range
;
13
-
137
months
)
.
In
the
vitrectomy
,
posterior
vitreous
detachment
either
occurred
or
was
confirmed
.
An
intentional
retinal
hole
was
made
and
the
subretinal
fluid
was
drained
through
the
hole
.
The
abnormal
vessels
were
coagulated
by
endo-diathermy
and
/
or
laser
photocoagulation
.
The
vitreous
fluid
was
replaced
with
long
-lasting
gas
or
air
.
The
visual
acuity
and
the
findings
from
the
ocular
fundus
both
before
and
after
the
vitrectomy
were
investigated
.
The
average
best-corrected
visual
acuities
in
decimal
equivalent
before
,
3
and
12
months
after
the
vitrectomy
,
and
at
the
final
visit
were
0
.
1
,
0
.
2
,
0
.
2
,
0
.
4
,
respectively
.
There
was
a
statistically
significant
(
p
=
0
.
007
)
difference
between
the
4
time
points
,
and
the
visual
acuities
at
12
months
after
vitrectomy
and
the
final
visit
were
significantly
(
p
<
0
.
05
)
better
than
before
the
vitrectomy
.
The
macular
part
of
the
retina
in
all
5
cases
was
attached
once
the
gas
in
the
vitreous
cavity
had
disappeared
.
The
foveal
exudation
which
was
observed
before
the
vitrectomy
in
all
5
cases
was
completely
absorbed
after
the
vitrectomy
.
The
average
period
from
the
vitrectomy
to
the
complete
absorption
of
the
exudation
was
20
months
.
Subfoveal
fibrosis
was
observed
in
4
of
the
5
eyes
and
chorioretinal
atrophy
occurred
in
3
.
Vitrectomy
for
eyes
with
Stage
3
A
Coats
disease
may
be
effective
for
visual
prognosis
compared
to
conventional
therapy
,
i
.
e
.
,
laser
photocoagulation
and
cryopexy
,
by
enabling
retinal
attachment
in
the
early
postoperative
period
and
by
causing
the
foveal
exudation
to
disappear
.
Diseases
Validation
Diseases presenting
"leading to persistent subretinal fluid and multiple courses of treatment"
symptom
coats disease
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