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目的 探讨晚期Coats病药物治疗和手术治疗的效果。方法 研究对象为1999年～2 0 0 4年间在我院经FFA确诊为晚期Coats病的患者共7例(7眼) ,平均年龄为14岁±5 . 8岁。7眼均有渗出性视网膜全脱离,3眼并发新生血管性青光眼。3例予以全身和局部激素以及活血化淤等药物治疗后,视网膜平复,行激光光凝术;另4眼予以玻璃体切割、视网膜切开、眼内激光光凝和硅油充填术。手术的4眼均未行硅油取出术。平均随访8 5个月。结果 药物治疗的3眼:在疗程的第12周～16周,视网膜下液逐渐吸收,2眼视网膜近完全平复,视力提高到0. 0 2以上。手术治疗的4眼:视网膜基本平复,视力无改善,术后周边视网膜均有增殖膜形成,其中并发新生血管性青光眼的3眼眼压均控制在10～15mmHg ,虹膜新生血管基本消退。结论 晚期Coats病的治疗需个体化方案。药物治疗和手术治疗均可减少视网膜下的渗出。玻璃体手术联合眼内光凝对并发新生血管性青光眼的Coats病的眼压控制有效,对视功能的恢复无益
Objective To investigate the effect of drug treatment and surgical treatment of advanced Coats disease. Methods A total of seven patients (7 eyes) with Fats diagnosed with advanced Coats disease in our hospital from 1999 to 2004 were recruited. The mean age was 14 years ± 5. 8 years old. All eyes had exudative retinal detachment and 3 eyes had neovascular glaucoma. 3 cases were treated with systemic and local hormones and drugs such as promoting blood circulation and resolving stasis. The retina was repaired by laser photocoagulation. The other 4 eyes were treated by vitrectomy, retinal incision, intraocular laser photocoagulation and silicone oil filling. 4 eyes were not removed silicone oil surgery. The average follow-up of 85 months. Results 3 drug treatment: in the course of the first 12 weeks to 16 weeks, subretinal fluid gradually absorbed, 2 eyes almost completely recovered the retina, visual acuity increased to more than 0.02. Surgical treatment of 4 eyes: the retina basically smooth, no improvement of visual acuity, proliferative membrane formation in the surrounding retina, including 3 cases of intraocular pressure associated with neovascular glaucoma were controlled at 10 ~ 15mmHg, iris neovascularization subsided. Conclusion The treatment of advanced Coats disease requires individualized treatment. Both drug treatment and surgical treatment reduce retinal exudation. Vitreous ophthalmologic surgery combined with intraocular photocoagulation is effective in controlling intraocular pressure in Coats disease associated with neovascular glaucoma, which is not beneficial to recovery of visual function