Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Vitreo-retinal Surgery in Advanced Coats' Disease

Besch D., Feudner E., Gelisken F., Szurman P., Rohrbach J. M., Bartz-Schmidt K. U. 
University Eye Hospital, Department I, Tübingen

Purpose: Coats disease, also called retinal telangiectasis, is characterized by a defect of retinal vascular development that results in vessel leakage, intra- and subretinal exudation, and retinal detachment. Initially, the condition is seen within a sector of the retina and at this stage may be associated with normal vision. However, the progressive changes often lead to visual loss. For treatment patients usually undergo selective laser-photocoagulation or cryocoagulation of the telangiectasis, but successful management of severe forms of Coats' disease is often difficult.
Method: This video will present vitreo-retinal surgical procedures in three patients with progressive Coats' disease including extended subretinal lipid exudation at the posterior pole, secondary vascular tumors and exudative retinal detachment. Before surgery, patients underwent laser-photocoagulation and / or cryotherapy; however, within few months a rapid worsening could be observed. After surgery, patients were monitored for 8 to 16 months.
Results: Possible indications for a vitreo-retinal surgical procedure in therapy-resistant Coats' disease will be demonstrated. The video shows the technique of vitreo-retinal surgery step by step (pars plana vitrectomy, retinectomy, subretinal drainage of the exudates, removal of a secondary tumour and fibrous membranes, cryocoagulation, lasercoagulation and instillati

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