Болезнь Коатса: современные аспекты лечения. Обзор литературы

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.

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