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Exudative retinopathy

MedGen UID:
102319
Concept ID:
C0154832
Disease or Syndrome
Synonyms: Coats disease; Retinal telangiectasis
SNOMED CT: Coats syndrome (360455002); Exudative retinopathy (25506007); Coats' disease (360455002); Miliary aneurysms of retina (360455002); Leber's miliary aneurysms (360455002)
Modes of inheritance:
Not genetically inherited
MedGen UID:
988794
Concept ID:
CN307044
Finding
Source: Orphanet
clinical entity without genetic inheritance.
 
HPO: HP:0007898
Monarch Initiative: MONDO:0010269
OMIM®: 300216
Orphanet: ORPHA190

Definition

Coats disease (CD) is an idiopathic disorder characterized by retinal telangiectasia with deposition of intraretinal or subretinal exudates, potentially leading to retinal detachment and unilateral blindness. CD is classically an isolated and unilateral condition affecting otherwise healthy young children. [from ORDO]

Clinical features

From HPO
Leukocoria
MedGen UID:
57540
Concept ID:
C0152458
Disease or Syndrome
An abnormal white reflection from the pupil rather than the usual black reflection.
Exudative retinal detachment
MedGen UID:
57823
Concept ID:
C0154822
Disease or Syndrome
A type of retinal detachment arising from damage to the outer blood-retinal barrier that allows fluid to access the subretinal space and separate the neurosensory retina from the retinal pigment epithelium.
Retinal telangiectasia
MedGen UID:
57598
Concept ID:
C0154835
Disease or Syndrome
Dilatation of small blood vessels of the retina.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVExudative retinopathy
Follow this link to review classifications for Exudative retinopathy in Orphanet.

Conditions with this feature

Osteoporosis with pseudoglioma
MedGen UID:
98480
Concept ID:
C0432252
Disease or Syndrome
Osteoporosis-pseudoglioma syndrome is a rare condition characterized by severe thinning of the bones (osteoporosis) and eye abnormalities that lead to vision loss. In people with this condition, osteoporosis is usually recognized in early childhood. It is caused by a shortage of minerals, such as calcium, in bones (decreased bone mineral density), which makes the bones brittle and prone to fracture. Affected individuals often have multiple bone fractures, including in the bones that form the spine (vertebrae). Multiple fractures can cause collapse of the affected vertebrae (compressed vertebrae), abnormal side-to-side curvature of the spine (scoliosis), short stature, and limb deformities. Decreased bone mineral density can also cause softening or thinning of the skull (craniotabes).\n\nMost affected individuals have impaired vision at birth or by early infancy and are blind by young adulthood. Vision problems are usually caused by one of several eye conditions, grouped together as pseudoglioma, that affect the light-sensitive tissue at the back of the eye (the retina), although other eye conditions have been identified in affected individuals. Pseudogliomas are so named because, on examination, the conditions resemble an eye tumor known as a retinal glioma.\n\nRarely, people with osteoporosis-pseudoglioma syndrome have additional signs or symptoms such as mild intellectual disability, weak muscle tone (hypotonia), abnormally flexible joints, or seizures.
Revesz syndrome
MedGen UID:
231230
Concept ID:
C1327916
Disease or Syndrome
Dyskeratosis congenita and related telomere biology disorders (DC/TBD) are caused by impaired telomere maintenance resulting in short or very short telomeres. The phenotypic spectrum of telomere biology disorders is broad and includes individuals with classic dyskeratosis congenita (DC) as well as those with very short telomeres and an isolated physical finding. Classic DC is characterized by a triad of dysplastic nails, lacy reticular pigmentation of the upper chest and/or neck, and oral leukoplakia, although this may not be present in all individuals. People with DC/TBD are at increased risk for progressive bone marrow failure (BMF), myelodysplastic syndrome or acute myelogenous leukemia, solid tumors (usually squamous cell carcinoma of the head/neck or anogenital cancer), and pulmonary fibrosis. Other findings can include eye abnormalities (epiphora, blepharitis, sparse eyelashes, ectropion, entropion, trichiasis), taurodontism, liver disease, gastrointestinal telangiectasias, and avascular necrosis of the hips or shoulders. Although most persons with DC/TBD have normal psychomotor development and normal neurologic function, significant developmental delay is present in both forms; additional findings include cerebellar hypoplasia (Hoyeraal Hreidarsson syndrome) and bilateral exudative retinopathy and intracranial calcifications (Revesz syndrome and Coats plus syndrome). Onset and progression of manifestations of DC/TBD vary: at the mild end of the spectrum are those who have only minimal physical findings with normal bone marrow function, and at the severe end are those who have the diagnostic triad and early-onset BMF.
Dyskeratosis congenita, autosomal dominant 3
MedGen UID:
462795
Concept ID:
C3151445
Disease or Syndrome
Dyskeratosis congenita and related telomere biology disorders (DC/TBD) are caused by impaired telomere maintenance resulting in short or very short telomeres. The phenotypic spectrum of telomere biology disorders is broad and includes individuals with classic dyskeratosis congenita (DC) as well as those with very short telomeres and an isolated physical finding. Classic DC is characterized by a triad of dysplastic nails, lacy reticular pigmentation of the upper chest and/or neck, and oral leukoplakia, although this may not be present in all individuals. People with DC/TBD are at increased risk for progressive bone marrow failure (BMF), myelodysplastic syndrome or acute myelogenous leukemia, solid tumors (usually squamous cell carcinoma of the head/neck or anogenital cancer), and pulmonary fibrosis. Other findings can include eye abnormalities (epiphora, blepharitis, sparse eyelashes, ectropion, entropion, trichiasis), taurodontism, liver disease, gastrointestinal telangiectasias, and avascular necrosis of the hips or shoulders. Although most persons with DC/TBD have normal psychomotor development and normal neurologic function, significant developmental delay is present in both forms; additional findings include cerebellar hypoplasia (Hoyeraal Hreidarsson syndrome) and bilateral exudative retinopathy and intracranial calcifications (Revesz syndrome and Coats plus syndrome). Onset and progression of manifestations of DC/TBD vary: at the mild end of the spectrum are those who have only minimal physical findings with normal bone marrow function, and at the severe end are those who have the diagnostic triad and early-onset BMF.
Cerebroretinal microangiopathy with calcifications and cysts 1
MedGen UID:
1636142
Concept ID:
C4552029
Disease or Syndrome
Dyskeratosis congenita and related telomere biology disorders (DC/TBD) are caused by impaired telomere maintenance resulting in short or very short telomeres. The phenotypic spectrum of telomere biology disorders is broad and includes individuals with classic dyskeratosis congenita (DC) as well as those with very short telomeres and an isolated physical finding. Classic DC is characterized by a triad of dysplastic nails, lacy reticular pigmentation of the upper chest and/or neck, and oral leukoplakia, although this may not be present in all individuals. People with DC/TBD are at increased risk for progressive bone marrow failure (BMF), myelodysplastic syndrome or acute myelogenous leukemia, solid tumors (usually squamous cell carcinoma of the head/neck or anogenital cancer), and pulmonary fibrosis. Other findings can include eye abnormalities (epiphora, blepharitis, sparse eyelashes, ectropion, entropion, trichiasis), taurodontism, liver disease, gastrointestinal telangiectasias, and avascular necrosis of the hips or shoulders. Although most persons with DC/TBD have normal psychomotor development and normal neurologic function, significant developmental delay is present in both forms; additional findings include cerebellar hypoplasia (Hoyeraal Hreidarsson syndrome) and bilateral exudative retinopathy and intracranial calcifications (Revesz syndrome and Coats plus syndrome). Onset and progression of manifestations of DC/TBD vary: at the mild end of the spectrum are those who have only minimal physical findings with normal bone marrow function, and at the severe end are those who have the diagnostic triad and early-onset BMF.

Professional guidelines

PubMed

Tawil R, Kissel JT, Heatwole C, Pandya S, Gronseth G, Benatar M; Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; Practice Issues Review Panel of the American Association of Neuromuscular & Electrodiagnostic Medicine
Neurology 2015 Jul 28;85(4):357-64. doi: 10.1212/WNL.0000000000001783. PMID: 26215877Free PMC Article
Yoo JH, Chodosh J, Dana R
Semin Ophthalmol 2011 Jul-Sep;26(4-5):261-9. doi: 10.3109/08820538.2011.588653. PMID: 21958172

Recent clinical studies

Etiology

Shields JA, Pellegrini M, Kaliki S, Mashayekhi A, Shields CL
JAMA Ophthalmol 2014 Feb;132(2):190-6. doi: 10.1001/jamaophthalmol.2013.6281. PMID: 24357334
Ittiara S, Blair MP, Shapiro MJ, Lichtenstein SJ
J AAPOS 2013 Jun;17(3):323-5. Epub 2013 Apr 19 doi: 10.1016/j.jaapos.2013.01.004. PMID: 23607977
Ferrone PJ, Chaudhary KM
Retina 2012 Mar;32(3):530-6. doi: 10.1097/IAE.0B013E318233AD26. PMID: 22374156
McCleary CD, Guier CP, Dunbar MT
Optometry 2004 Dec;75(12):756-70. doi: 10.1016/s1529-1839(04)70235-3. PMID: 15624672
Merimee TJ, Zapf J, Froesch ER
N Engl J Med 1983 Sep 1;309(9):527-30. doi: 10.1056/NEJM198309013090904. PMID: 6348545

Diagnosis

Agrawal S, Shanmugam PM, Shah PN, Mishra DK, Ramanjulu R
Ophthalmic Surg Lasers Imaging Retina 2022 Jun;53(6):346-348. Epub 2022 Jun 1 doi: 10.3928/23258160-20220421-01. PMID: 35724369
Nieves-Moreno M, Peralta J, Noval S
Eur J Ophthalmol 2022 Nov;32(6):3289-3294. Epub 2022 Feb 8 doi: 10.1177/11206721221078678. PMID: 35132889
Barbaro PM, Ziegler DS, Reddel RR
Intern Med J 2016 Apr;46(4):393-403. doi: 10.1111/imj.12868. PMID: 26247919
Reichstein DA, Recchia FM
Int Ophthalmol Clin 2011 Winter;51(1):93-112. doi: 10.1097/IIO.0b013e318200de51. PMID: 21139479
Riyaz A, Riyaz N, Jayakrishnan MP, Mohamed Shiras PT, Ajith Kumar VT, Ajith BS
Indian J Pediatr 2007 Sep;74(9):862-3. doi: 10.1007/s12098-007-0155-2. PMID: 17901676

Therapy

Hoşnut FÖ, Şahin G, Akçaboy M
Turk J Pediatr 2022;64(1):166-170. doi: 10.24953/turkjped.2020.3315. PMID: 35286046
Kumar K, Raj P, Chandnani N, Agarwal A
Int Ophthalmol 2019 Feb;39(2):465-470. Epub 2018 Jan 29 doi: 10.1007/s10792-018-0827-0. PMID: 29380183
Fay AJ, King AA, Shimony JS, Crow YJ, Brunstrom-Hernandez JE
Pediatr Neurol 2017 Jun;71:56-59. Epub 2017 Mar 23 doi: 10.1016/j.pediatrneurol.2017.03.008. PMID: 28424147Free PMC Article
Yannuzzi NA, Tzu JH, Hess DJ, Berrocal AM
Ophthalmic Surg Lasers Imaging Retina 2014 Mar-Apr;45(2):172-4. doi: 10.3928/23258160-20140306-13. PMID: 24635161
Ittiara S, Blair MP, Shapiro MJ, Lichtenstein SJ
J AAPOS 2013 Jun;17(3):323-5. Epub 2013 Apr 19 doi: 10.1016/j.jaapos.2013.01.004. PMID: 23607977

Prognosis

Karremann M, Neumaier-Probst E, Schlichtenbrede F, Beier F, Brümmendorf TH, Cremer FW, Bader P, Dürken M
Orphanet J Rare Dis 2020 Oct 23;15(1):299. doi: 10.1186/s13023-020-01553-y. PMID: 33097095Free PMC Article
Ittiara S, Blair MP, Shapiro MJ, Lichtenstein SJ
J AAPOS 2013 Jun;17(3):323-5. Epub 2013 Apr 19 doi: 10.1016/j.jaapos.2013.01.004. PMID: 23607977
Ferrone PJ, Chaudhary KM
Retina 2012 Mar;32(3):530-6. doi: 10.1097/IAE.0B013E318233AD26. PMID: 22374156
Riyaz A, Riyaz N, Jayakrishnan MP, Mohamed Shiras PT, Ajith Kumar VT, Ajith BS
Indian J Pediatr 2007 Sep;74(9):862-3. doi: 10.1007/s12098-007-0155-2. PMID: 17901676
McCleary CD, Guier CP, Dunbar MT
Optometry 2004 Dec;75(12):756-70. doi: 10.1016/s1529-1839(04)70235-3. PMID: 15624672

Clinical prediction guides

Fay AJ, King AA, Shimony JS, Crow YJ, Brunstrom-Hernandez JE
Pediatr Neurol 2017 Jun;71:56-59. Epub 2017 Mar 23 doi: 10.1016/j.pediatrneurol.2017.03.008. PMID: 28424147Free PMC Article
Thanos A, Todorich B, Hypes SM, Yonekawa Y, Thomas B, Randhawa S, Drenser KA, Trese MT
Retin Cases Brief Rep 2017 Winter;11 Suppl 1:S187-S190. doi: 10.1097/ICB.0000000000000430. PMID: 27685501
Sinawat S, Thanapaisal S, Sinawat S
J Med Assoc Thai 2014 Oct;97 Suppl 10:S110-4. PMID: 25816546
Hingorani M, Williamson KA, Moore AT, van Heyningen V
Invest Ophthalmol Vis Sci 2009 Jun;50(6):2581-90. Epub 2009 Feb 14 doi: 10.1167/iovs.08-2827. PMID: 19218613
Paisey RB, Arredondo G, Villalobos A, Lozano O, Guevara L, Kelly S
Diabetes Care 1984 Sep-Oct;7(5):428-33. doi: 10.2337/diacare.7.5.428. PMID: 6499636

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