helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2025-18-4-185-189helmholtzeyeinstitute-1974Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSБолезнь Коатса: современные аспекты лечения. Обзор литературыCoats' disease: current treatment trends. A literature reviewhttps://orcid.org/0000-0003-1038-2746НероеваН. В.NeroevaN. V.

Наталия Владимировна Нероева — д-р мед. наук, руководитель отдела патологии сетчатки и зрительного нерва

, ул. Садовая-Черногрязская, д. 14/19, 105062

Natalia V. Neroeva — Dr. of Med. Sci., head of the department of pathology of the retina and optic nerve

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

ТанковскийВ. Э.TankovskiyV. E.

Владимир Эдуардович Танковский — д-р мед. наук, старший научный сотрудник отдела патологии сетчатки и зрительного нерва, доцент кафедры непрерывного медицинского образования

, ул. Садовая-Черногрязская, д. 14/19, 105062

Vladimir E. Tankovskiy  — Dr. of Med. Sci., senior researcher of the department of pathology of the retina and optic nerve, associate professor of chair of continuing medical education

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

https://orcid.org/0000-0003-0556-0149УшаковА. И.UshakovA. I.

Александр Игоревич Ушаков — младший научный сотрудник отдела патологии сетчатки и зрительного нерва

, ул. Садовая-Черногрязская, д. 14/19, 105062

Alexander I. Ushakov — junior researcher of the department of retina and optic nerve pathology

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

winter215@yandex.ruФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава РоссииРоссияHelmholtz National Medical Research Center of Eye DiseasesRussian Federation202509012026184185189Copyright © Нероева Н.В., Танковский В.Э., Ушаков А.И., 20262026Нероева Н.В., Танковский В.Э., Ушаков А.И.Neroeva N.V., Tankovskiy V.E., Ushakov A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/1974

В 1908 г. Д. Коатс впервые описал группу пациентов с поражением органа зрения, которое проявляется телеангиэктазиями с массивной интраи субретинальной экссудацией, приводящей к локальной элевации сетчатки и/или ее полной отслойке. До настоящего времени не разработано общепринятой модели патогенеза и не выявлены причины болезни Коатса (БК). Предполагалось, что причиной заболевания может быть инфекционный процесс, воспалительная реакция, но единого мнения на этот счет в настоящее время нет. По последним данным, у пациентов с БК в субретинальной, внутриглазной жидкости и стекловидном теле повышена концентрация VEGF, IL-6, IL-1b и МСР-1. Из возможных осложнений БК можно выделить вазопролиферативные опухоли, неоваскулярную глаукому, интраретинальные кровоизлияния, гемофтальм, фиброз стекловидного тела, тракционную отслойку сетчатки. Лечение БК включает лазерную терапию, криотерапию, интравитреальное введение глюкокортикостероидов и ингибиторов ангиогенеза. В запущенных случаях возможно применение витреоретинальной хирургии. В терминальной стадии БК может потребоваться энуклеация.

In 1908, G. Coats first described a group of patients with eye damage, manifested by telangiectasia with massive intraand subretinal exudation, leading to local elevation of the retina and/or its complete detachment. Until now, a generally accepted pathogenesis model has not been developed and the causes of Coats disease (CD) have not been identified. It was assumed that the cause of the disease could be an infectious process, an inflammatory reaction, but there is currently no consensus on this issue. A study of the cytokine profile showed an increased concentration of VEGF in the intraocular, subretinal fluid and vitreous humor, an increase in the concentration of IL-6, IL-1b and MCP-1 levels was also noted. Complications of CD include vasoproliferative tumors, neovascular glaucoma, intraretinal and intraocular hemorrhages, vitreous fibrosis, traction retinal detachment. CD treatment includes laser coagulation, cryotherapy, intravitreal administration of glucocorticosteroids and angiogenesis inhibitors. In severe forms and advanced stages of CD, vitreoretinal surgery is resorted to. Enucleation may be necessary is some cases.

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The authors declare that there are no conflicts of interest present.