Gary Shienbaum

Bio: Gary Shienbaum is an academic researcher from Wills Eye Institute. The author has contributed to research in topics: Coats' disease. The author has an hindex of 1, co-authored 1 publications receiving 31 citations.

Coats disease: a lifetime disease.

Abstract: Purpose To document the recurrent nature of Coats Disease. Methods This study is a retrospective chart review approved by our Institutional Review Board. Thirteen patients (13 eyes) were diagnosed with Coats Disease starting in 1966. Age, visual acuity, time of onset, method of treatment, and the number and intervals of recurrences were documented. Recurrences were recorded once initial treatment proved successful and most exudates had absorbed. The length of follow-up for each patient and the most recent visual acuity was recorded. Results The average follow-up period for the 13 patients was 12.4 years with a range from 4.0 to 37.5 years. Eleven patients (85%) were male, two (15%) were female and all had unilateral involvement. The average age at diagnosis was 7.0 years with a range from 9 months to 27 years. Four out of the twelve treated patients (33%) had recurrences, and three of the four had multiple recurrences. The average elapsed time from successful treatment to the first recurrence was 4.3 years with a range from 3.3 to 5.4 years. The average number of recurrences was 3.3. Conclusion Coats Disease can recur so it is important that parents educate any affected children regarding the necessity of follow-up, including throughout their adult years.

Diagnosis and treatment of coats' disease: a review of the literature.

Abstract: Coats' disease is an idiopathic, ophthalmic condition characterized by retinal telangiectasis, intraretinal and subretinal exudation, which can lead to retinal detachment. It is mostly unilateral, progressive and affects mainly males during childhood, although adult cases have also been described. In this review, we make an update of the literature about Coats' disease, emphasizing on diagnosis and treatment, including the most recent treatment modalities, i.e. anti-vascular endothelial growth factor agents.

Advanced Coats' disease. Management with repetitive aggressive laser ablation therapy.

Abstract: PURPOSE To review the rates of globe salvage and final visual acuity outcomes for patients undergoing repetitive laser ablation therapy for advanced Coats' disease. METHODS This study was a retrospective chart review of all patients diagnosed with primary Coats' disease treated on the Ocular Oncology Service of the Bascom Palmer Eye Institute from 1991-2006. Patients underwent repetitive diode laser ablation (two to nine sessions) to telangiectatic vessels and areas of exudative retinal detachment. Main outcome measures included ability to achieve globe salvage, final visual acuity, and anatomic success. RESULTS Seventeen patients were identified who met all of the inclusion criteria for the study. All of the eyes in this study had advanced disease with some degree of exudation with or without a retinal detachment. The median length of follow-up was 10 months (mean, 21 months). The median number of laser applications required was 4.8 (mean, 5). Fourteen patients (82%) achieved anatomic success with complete resolution of the telangiectasis and exudative retinal detachments. Sixteen patients (94%) achieved globe salvage. The final visual acuity was excellent (20/20-20/50) in 7 patients (47%), moderate (20/60-20/100) in 1 patient (7%), and poor (worse than 20/200) in 7 patients (47%). CONCLUSION A majority of patients with Coats' disease can achieve globe salvage and about half of patients can retain useful vision with aggressive repetitive diode laser therapy even if the disease is very advanced at presentation.

Pearls and pitfalls in diagnosis and management of coats disease.

Abstract: Purpose:To review current literature on Coats disease and provide a structured framework for differentiating challenging clinical features in Coats disease patients.Methods:We critically reappraise historical and current literature and present clinical methods for developing a thorough differential

Coats' disease: An Indian perspective

Abstract: Aim: To describe the clinical features, treatment and outcome patterns in 307 eyes with Coats' disease. Materials and Methods: Retrospective chart review of patients diagnosed with Coats' disease between January 1996 and January 2006 from a single referral center in southern India. Results: Two hundred and eighty patients (307 eyes) with mean age of 15.67 years (range: Four months-80 years) were included. Decreased vision (77%), unilateral affection (90%) and male preponderance (83.4%) were chief presenting features. Anterior segment involvement was seen in 67 (21.8%) eyes. Retinal telangiectasia were seen in 302 (99%) eyes, exudation in 274 (89%) eyes and retinal detachment in 158 (51.5%) eyes. Four-quadrant disease was seen in 207 (67.2 %) eyes. Visual acuity was < 20/200 in 249 (80.9%) eyes. One hundred and nine of 176 treated eyes (61.93%) had favorable anatomical outcome; 207 of 280 eyes (74%) had an optimal structural outcome. Seventeen (5.3%) eyes were enucleated. Complications following treatment included phthisis bulbi (7%), neovascular glaucoma (5%), epiretinal membrane (4.4%) and rubeosis iridis (4.4%). Conclusion: Indian patients with Coats' disease have a high male predominance, the majority of whom present with severe visual impairment and extensive four-quadrant exudation. Unusual presentations such as pain, vitreous hemorrhage and a high incidence of anterior segment involvement are distinctive to Indian eyes.