Coats retinitis is a serious rare disease that is inherited. Most often, the pathology spreads to one eye. The most susceptible to this disease are boys from 5 to 10 years. However, Retinitis Coats may occur in adulthood. The main symptoms, stages and treatment - we will talk in more detail about everything you need to know.
More about the disease
The disease affects the choroid of the eye. The inflammatory process takes place on the retina, and vision is significantly reduced. The main danger is the development of a number of complications, up to complete blindness.
Often the inflammatory process in the retina is due to the pathology of pathogens. As pathogens are:
- staphylococcus;
- pale treponema;
- Pneumococcus;
- streptococcus;
- a number of adenoviruses;
- measles or influenza viruses;
- tuberculosis microbacterium.
The disease is inflammatory and infectious. Rarely, Coats' Retinitis develops in isolation as a manifestation of pathology.
There are two photosensitive nerve endings in the inner lining of the eye: rods and cones. The rods are responsible for providing peripheral and twilight vision, and cones for color reproduction and visual acuity. In the case of pathology in the photosensitive layer of the eye, visual impairment occurs.
If the retina is damaged, then inflammation can occur in the choroid. This pathology is called choroiditis. With the progression of pathology, the patient develops a disease of chorioretinitis.
Coats Retinitis: Causes
The appearance and development of the disease is provoked by simple microbes, parasites and viruses. Among the most common causes are the following:
- diseases that develop due to infection of the body by pathogenic flora;
- with collagenosis;
- with increased allergic reactions in the body;
- with diseases of the endocrine system;
- with injuries of the organs of vision;
- with intoxication of the body;
- with high-energy radiation.
Often, pathology occurs due to infections introduced into the body with syphilis, tuberculosis, toxoplasmosis. In addition, the causes of the disease are purulent and viral infections.
The causative agent of the disease penetrates through the bloodstream into the organ of vision. Coats retinitis develops simultaneously with the first exacerbation of pyelonephritis and pathogenic microflora. Often the cause of the onset of the disease can be hidden in the general infection of the blood, meningitis and endocarditis.
Retinitis often occurs due to pathogenic bacterial flora, less often - as a result of viral infection.
The eye and vision are affected by injury or damage to the photosensitive membrane of the eye. The negative effects of ionizing radiation can also provoke retinitis.
Coats Retinitis: Symptoms
The first sign of the disease is blurred vision. This is especially evident if one eye is closed (healthy). In the early stages of the disease, the eye is red and hurts.
A healthy eye will take on the whole load. Therefore, the overall level of vision will not decrease. However, the ability to distinguish the position of objects far away will suffer significantly. This symptom is called parallax.
The second symptom is leukocoria, better known as the "yellow eye." This symptom manifests itself when photographing a child with a flash. In the picture, the affected eye will be yellow. A healthy eye is red and hurts. This is a “troubling" symptom.
With the development of pathology, microcirculation will occur. It will drain into the lower parts of the eye. Consequently, vision will fall significantly. In this case, both peripheral and central vision will suffer.
Additional symptoms of this disease include the following symptoms:
- color perception is impaired;
- the picture is split / blurred before the eyes;
- disturbances in the vessels;
- tunnel vision;
- retinal hemorrhage;
- blindness in the dark - a sign of retinitis pigmentosa;
- night blindness;
- the optic nerve atrophies.
During the progression of retinitis, flashes of light and frequent “flies” in the eyes will appear in front of the eyes.
If exudate (the fluid that accumulates during inflammation) does not respond to treatment, secondary glaucoma gradually develops.
Stages
Coats retinitis occurs in 4 stages. Each of them has two degrees: A and B.
- The initial stage begins imperceptibly. Pain in the eyes is not felt, but a marked decrease in vision in one eye.
- The retina exfoliates. At this stage, visual acuity always drops sharply. Flashes of light and spots appear before the eyes, the field of view is disturbed. Often, as an additional sign, glaucoma and cataracts develop.
- Irreversible changes. At this stage, a high degree of retinal detachment. On the sore eye, vision is lost. Secondary glaucoma develops. In the affected tissues of the eye, blood circulation decreases sharply. This leads to the fact that the inflammatory process proceeds in an active form.
- Terminal stage. In the fourth stage, the eye atrophies. Specialist intervention is needed to remove the eyeball.
Classification: Retinitis Forms
Given the causes of the onset of the disease, doctors classify into several types. Often, pathology is divided into two types: exogenous and endogenous. The first type arises as a result of the influence of external factors, the second is a consequence of internal pathological processes.
Coats retinitis is classified into the following forms:
- viral retinitis;
- tuberculous
- septic;
- syphilitic;
- rheumatic;
- toxoplasmosis;
- cytomegalovirus;
- brucellosis;
- pseudoalbuminuretic;
- diabetic;
- leukemic;
- retinitis pigmentosa;
- exudative (Coats disease).
Viral retinitis occurs due to pathogens such as herpes virus, adenovirus, influenza virus. Pathology manifests itself in the form of a change in the retina: slight opacification, the formation of white spots of various shapes and sizes.
Cytomegalovirus retinitis is a disease that develops against the background of human immunodeficiency, possibly HIV. A slowly growing retinal focus is formed on the fundus. With progression, it affects the entire retina. Perhaps the development of hematogenous detachment of the photosensitive layer.
Syphilitic retinitis can occur due to the ingestion of pale treponema in the child's body . This is possible at the birth of a baby with congenital syphilis. The disease is characterized by the formation of various foci of white color. Often they are mixed with dark ones. This pathology lasts for life.
Tuberculous retinitis in the organ of vision occurs if the eye is affected by microbial bacteria. During the progression of this type of disease, hemophthalmitis appears: blood enters the thickness of the vitreous body. As a result, tractional retinal detachment.
Diabetic retinitis can develop if a person suffers from diabetes. When the condition worsens, transmission of blood and other fluid into the walls of the retina is observed. The vessels increase and become weak. Progression of the disease can cause cataracts.
Heredity - retinitis pigmentosa
This type of retinitis can develop as a result of dystrophy. The disease manifests itself under the influence of a hereditary factor. Degenerative processes appear in the retina that are directly associated with abnormalities of the photoreceptors and pigment epithelium in the human body. As a result, the loss of a large number of photoreceptors and the development of blindness of varying degrees.
Pathology detection
Coats retinitis is diagnosed using the following methods:
- examination by a specialist organ of vision;
- X-ray examination;
- CT scan;
- standard test for visual acuity;
- visiometry - it is possible to check visual acuity at a minimum angle;
- conducting a color test to determine the field of view and the intervals of loss of vision;
- computer perimetry - an examination that helps to identify dysfunction in the work of peripheral and central vision;
- ophthalmoscopy - a method of examination of the fundus;
- biomicroscopy is a non-contact diagnostic technique for the eye environment and its structure using a slit lamp.
Of importance is an ophthalmoscopic examination of the fundus.
In addition, the examination gives the right to establish the general condition of the patient.
Treatment
Treatment should be comprehensive. Where to treat Coats retinitis? Mandatory in a hospital setting. The method of therapy is caused by the cause of the disease. Based on the results of the examination, the doctor makes a decision on the further way of treatment - surgical or medical.
Retinal laser coagulation is usually performed in a hospital setting. With the help of an ophthalmic laser apparatus, the inner membrane of the retina is cauterized.
Necessarily laser coagulation of the retina is carried out through a special focusing lens. After the operation is completed, it is necessary to do the instillation under a local antiseptic.
Laser eye surgery is indicated at stages 1 and 2 of the disease. Contraindications: retinal hemorrhage, cataract, epiretinal gliosis.
Cryocoagulation
This is a kind of laser eye surgery. The affected areas of the retina are affected by cold in order to form adhesions of the retina and choroid. The operation is performed under local anesthesia. It is possible to conduct operations in the operating room at a local clinic.
With indirect ophthalmoscopy, the affected area is cauterized. This greatly improves blood circulation to healthy areas of the eye and slows down retinal detachment. After the procedure, antibacterial drops are dropped into the eyes and a bandage is applied.
Vitreoretinal Surgery
This is a partial removal of the intraocular structure of the vitreous. Such an operation should be carried out only in a specialized clinic.
The vitreous body is completely or partially removed, after which the drainage system is installed. The eye is sutured with an x-shaped suture. The operation is indicated for partial or complete rupture of the retina. However, under one condition: a stable level of eye pressure.
Surgical intervention is contraindicated in the presence of malignant tumors in the organ of vision.
Conservative treatments
Drug treatment of this disease involves the use of various means:
- antibiotics to identify a bacterial cause (Tetracycline);
- local glucocorticosteroids (in the form of a gel, drops, ointments): Dexamethasone, Methylprednisolone;
- antiviral drugs (instillation, injection): "Half-day", "Acyclovir";
- special anti-tuberculosis drugs;
- drugs that increase metabolism and improve the state of the vascular system (vitamins of groups A, E, B, Solcoseryl);
- preparations for strengthening the vascular walls (Ascorutin, Dicinon, ascorbic acid.
Additionally, drugs may be prescribed to accelerate tissue repair.
Complications
Coats retinitis causes quite serious complications. The consequences are: visual impairment, loss of certain fields of vision. If the patient was diagnosed with a "yellow spot", then loss of vision in one eye is possible.
With severe inflammation, hemorrhage occurs. As a result, retinal detachment and the occurrence of severe blindness.
If treatment is ignored, then atrophy or optic neuritis is possible, retinal detachment will cause complete loss of vision.
Prevention
Preventive measures will avoid the development of a serious disease. Ophthalmologists recommend:
- Finish off viral and bacterial infections, as well as diseases caused by inflammation.
- Prevent the development of complications.
- Take care of the organs of vision, in particular from exposure to UV rays.
- If there is a diabetes mellitus disease, then be examined regularly by a specialist.
- Carry out immuno-reinforcing procedures.
- If you experience the first symptoms, consult a doctor immediately.
When performing basic preventive rules, the development of retinitis can be avoided.
Who recovered from the illness?
According to statistics, it is known that not one person fully recovered the function of vision with this diagnosis after surgery.
Many patients live with retinitis safely. However, there are a number of forms of retinitis that can lead not only to blindness, but also to death. In case of timely treatment, undesirable consequences can be avoided.
Do not put off visiting a doctor. When the first signs of retinitis appear, immediately go to the hospital. Remember that the guarantee of your health is a timely visit to a doctor. Your health is in your hands!