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Morbus Coats

Wichtige Differenzialdiagnose zum Retinoblastom

Coats’ disease

Important differential diagnosis for retinoblastoma

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Zusammenfassung

Der fortgeschrittene Morbus Coats stellt im Kleinkindalter eine der schwierigsten Differenzialdiagnosen zum Retinoblastom dar. Wir beschreiben die klinischen und histologischen Befunde zweier Jungen im Alter von 9 und 21 Monaten mit einseitiger Leukokorie. Trotz umfassender Diagnostik mittels Narkoseuntersuchung, MRT und Ultraschall konnte ein Retinoblastom nicht sicher ausgeschlossen werden, und es erfolgte eine Enukleation. Histologisch wurde die Diagnose eines Morbus Coats gesichert. Da eine differenzialdiagnostische Abgrenzung zwischen Morbus Coats und Retinoblastom schwierig sein kann, halten wir in zweifelhaften Fällen auch angesichts der eingeschränkten Visusprognose und potenzieller Sekundärkomplikationen beim fortgeschrittenen Morbus Coats eine Enukleation für indiziert.

Abstract

Advanced Coats’ disease is one of the most difficult differential diagnoses of retinoblastoma in early childhood. We describe the clinical and histological findings in two boys, ages 9 months and 21 months, with unilateral leucocoria. Despite comprehensive diagnostics that included examination under general anaesthesia, magnetic resonance imaging, and ultrasound, retinoblastoma could not be excluded, and the eyes were enucleated. Histological diagnosis of Coats’ disease was confirmed. Because differentiation between retinoblastoma and Coats’ disease may be difficult, enucleation seems to be indicated in uncertain cases due to the reduced visual prognosis and the risk of secondary complications in advanced Coats’ disease.

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Correspondence to B. Förl.

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Förl, B., Schmack, I., Grossniklaus, H. et al. Morbus Coats. Ophthalmologe 105, 761–764 (2008). https://doi.org/10.1007/s00347-007-1645-3

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