The infectious status of patients with Coats disease

Purpose of this work is to study the prevalence of various chronic infections, the frequency of their reactivation and associations of microorganisms in patients with Coats' disease. Material and methods. A retrospective analysis of medical records of 30 patients (36 eyes) aged from 18 to 78 years (mean 45.6 ± 15.8 years) with Coats' disease, who were treated in the Department of Retinal and Optic Nerve Pathology of the Helmholtz National Medical Research Center of Eye Diseases in the period from 2008 to 2023. To assess the infectious status of patients by the enzyme-linked immunosorbent assay (ELISA) method on the automatic ELISA analyzer "Lazurit" (USA) with the diagnostic test systems "Vector-Best" (Koltsovo) were determined serological markers of ophthalmotropic infections: antibodies to herpes viruses — herpes simplex virus (HSV) type 1 (HSV 1), HSV type 2 (HSV 2), cytomegalovirus (CMV), Epstein — Barr virus (EBV), as well as toxoplasma gondii, toxocara canis, chlamydia trachomatis, chlamydophila pneumoniae, mycoplasma hominis, ureaplasma urealyticum. Results. Serological markers of HSV 1 reactivation were most frequently detected in patients with Coats disease (64.7%). Most patients had mixed infection with a predominance of 4 or more ophthalmotropic infection pathogens. There is a tendency for markers of HSV type 1 reactivation to predominate in men and CMV in women. In the early stages of the disease, reactivation of herpes viruses (HSV 1, HSV 2, CMV, EBV) was detected in 40% of patients, and in the late stages in 26.6%. There are known features of the interaction of the virus with host cells, which lead to stimulation of VEGF-A synthesis by several mechanisms, which eventually manifests itself in the form of vascular abnormalities, which are characteristic, perhaps, of Coats disease. Conclusion. The features of the interaction of the virus with host cells, which lead to stimulation of VEGF-A synthesis by several mechanisms, ultimately manifest themselves in vascular changes, which are possibly characteristic of Coats disease.

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