Coats病眼底病变特点分析资料.doc

Coats病眼底病变分析 作者单位：河北医科大学第二医院眼科 050000,修改与安建斌联系，ajb21130@ 作者单位：河北医科大学第二医院眼科 050000,修改与安建斌联系，ajb21130@ 手通讯作者：马景学，Email:majingxue2003@ 摘要 目的 回顾性研究初诊Coats病205例211只眼的临床资料，分析并总结其眼底病变特点。方法：根据检眼镜眼底检查和眼底造影确定病变性质、部位、范围及病变程度，探究病变分布及发展规律。结果：211只患眼中，100%有微血管异常扩张；异常扩张的微血管90.1%位于颞侧，73.9%位于赤道以前，72.5%波及2个以上象限；90.5%伴有黄白色脂质渗出；86.3%黄斑受累；68.2%出现视网膜毛细血管无灌注区；38.9%可见视网膜出血；20.4%发生渗出性视网膜脱离；9.0%出现视网膜新生血管；0只眼发生玻璃体积血和玻璃体视网膜牵拉。结论：Coats病最本质特征是特发性视网膜毛细血管和微血管异常扩张，绝大部分位于颞侧赤道以前；通常伴有黄白色脂质渗出，范围较广多波及黄斑，严重者发生渗出性视网膜脱离；可出现视网膜毛细血管无灌注区和视网膜新生血管，但出血较少；几乎不发生玻璃体积血和玻璃体视网膜牵拉。 关键词：Coats 病，视网膜疾病 Fundus Analysis of 205 Coats Disease An Jian-bin,Ma Jing-xue,Liu Li-ya,Yang Ai-qin. Department of Ophthalmology,Second Clinical Hospital of Hebei Medical University.Shijiazhuang, China.050000. Objective To analyse the clinical data of the first presentation of 205 Coats disease (211 eyes) and summarize its fundus characteristics. Methods All patients had undergone ophthalmoscopy, ocular fundus photography and fundus fluorescein angiography. Results Dilated vessels occurred in all 211 (100%) eyes, located in temporal retina in 190 (90.1%) eyes and in midperipheral or peripheral retina in 156 (73.9%) eyes. The range of dilated vessels spreaded to two or fewer quadrants in 75.2% of all eyes.Retinal exudation occurred in 191 (90.5%) eyes and macular harm occurred in 182 (86.3%) eyes.Retinal capillary nonperfusion was present in 144 (68.2%) eyes. Retinal hemorrhage and retinal neovascularization was present in 82 (38.9%) eyes and in 39 (18.5%) eyes respectively. There was a exudative retinal detachment in 43 (20.4%) eyes.There was no vitreous hemorrhage and retinal-vitreal traction in all 211eyes. Conclusions Coats disease is a distinct clinical entity characterized by idiopathic retinal telangiectasia which locates mostly in temporal-peripheral fundus.Retinal exudation is usually present,which spreads widely and almost does harm to macula. Severe retinal exudation can causes exudative retinal detachment. There