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Retinal angiomatous proliferation with chorioretinal anastomosis in childhood Coats disease: a reappraisal of macular fibrosis using multimodal imaging.

AbstractPURPOSE:
To describe the structural characteristics of retinal angiomatous proliferation and chorioretinal anastomosis in childhood Coats disease and redefine the previously described macular fibrosis.
METHODS:
Prospective observational case series of consecutive patients with Coats disease examined over a 1-year study period. Multimodal imaging, including color fundus photography, wide-field fluorescein angiography, and spectral domain optical coherence tomography, was used to identify the features of macular retinal angiomatous proliferation and chorioretinal anastomosis.
RESULTS:
Retinal angiomatous proliferation and chorioretinal anastomosis were present in 5 of 21 patients with Coats disease (24%). The lesions appeared as well demarcated, nodular retinal pigment epithelial detachments surrounded by exudate, with retinal vessels continuous with the underlying choroidal neovascularization.
CONCLUSION:
Retinal angiomatous proliferation and chorioretinal anastomoses are features observed in a number of children (24% in the present series) with Coats disease and macular involvement. This lesion represents a distinct macular variant of Coats disease that underlies at least a proportion (all in the present series) of the previously described "macular fibrosis" and "subretinal mounds."
AuthorsEric J Sigler, Jorge I Calzada
JournalRetina (Philadelphia, Pa.) (Retina) Vol. 35 Issue 3 Pg. 537-46 (Mar 2015) ISSN: 1539-2864 [Electronic] United States
PMID25170864 (Publication Type: Case Reports, Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
Topics
  • Angiogenesis Inhibitors (therapeutic use)
  • Antibodies, Monoclonal, Humanized (therapeutic use)
  • Arterio-Arterial Fistula (diagnosis, therapy)
  • Bevacizumab
  • Child
  • Child, Preschool
  • Choroidal Neovascularization (diagnosis)
  • Combined Modality Therapy
  • Female
  • Fibrosis
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Laser Coagulation
  • Macula Lutea (pathology)
  • Male
  • Multimodal Imaging
  • Photography
  • Prospective Studies
  • Retinal Artery (pathology)
  • Retinal Neovascularization (diagnosis, therapy)
  • Retinal Pigment Epithelium (pathology)
  • Retinal Telangiectasis (diagnosis, therapy)
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A (antagonists & inhibitors)
  • Young Adult

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