PURPOSE: To measure peripheral nonperfusion and describe bilateral vascular abnormalities in patients with Coats disease, emphasizing subtle findings in the contralateral eyes of patients diagnosed with unilateral disease. METHODS: Clinical records, including retina drawings and fluorescein angiography images obtained under anesthesia, were retrospectively reviewed from consecutive pediatric patients with Coats disease. The main outcome measure was disk diameters of peripheral nonperfusion and proportion of Coats disease patients with bilateral findings. RESULTS: Twenty-two of 32 patients with Coats disease had bilateral abnormal peripheral vasculature. In Group 1 (classic Coats disease: presumed unilateral, ocular only disease), 15 of 24 patients had peripheral nonperfusion >2 disk diameters in their contralateral eyes, 5 with telangiectasis and/or microaneurysms. Seven of 8 patients in Group 2 (Coats-like disease: systemic and/or clinically bilateral disease) had bilateral vascular anomalies. CONCLUSION: Bilateral vascular abnormalities are more common in Coats disease than previously reported. This observation supports a systemic and/or genetic association with Coats disease. Patients with Coats disease should have careful evaluation of the periphery of the less affected eye, preferably with fluorescein angiography, to identify vascular changes not visible clinically. Both eyes warrant surveillance over the lifetime of the patient for potential progression to exudative disease that would warrant treatment.
PURPOSE: To measure peripheral nonperfusion and describe bilateral vascular abnormalities in patients with Coats disease, emphasizing subtle findings in the contralateral eyes of patients diagnosed with unilateral disease. METHODS: Clinical records, including retina drawings and fluorescein angiography images obtained under anesthesia, were retrospectively reviewed from consecutive pediatric patients with Coats disease. The main outcome measure was disk diameters of peripheral nonperfusion and proportion of Coats diseasepatients with bilateral findings. RESULTS: Twenty-two of 32 patients with Coats disease had bilateral abnormal peripheral vasculature. In Group 1 (classic Coats disease: presumed unilateral, ocular only disease), 15 of 24 patients had peripheral nonperfusion >2 disk diameters in their contralateral eyes, 5 with telangiectasis and/or microaneurysms. Seven of 8 patients in Group 2 (Coats-like disease: systemic and/or clinically bilateral disease) had bilateral vascular anomalies. CONCLUSION:Bilateral vascular abnormalities are more common in Coats disease than previously reported. This observation supports a systemic and/or genetic association with Coats disease. Patients with Coats disease should have careful evaluation of the periphery of the less affected eye, preferably with fluorescein angiography, to identify vascular changes not visible clinically. Both eyes warrant surveillance over the lifetime of the patient for potential progression to exudative disease that would warrant treatment.
Authors: Karen W Jeng-Miller; Taha Soomro; Nathan L Scott; Prethy Rao; Elizabeth Marlow; Emmanuel Y Chang; Anna Ells; Felix Chau; Eric Nudleman; Charles M Calvo; Nish Patel; Roy Schwartz; Linda A Cernichiaro-Espinosa; Alexandrea Gabrielle Montoya; Jessica Goldstein; C Armitage Harper; Caroline R Baumal; Mary Elizabeth Hartnett; J William Harbour; Cagri G Besirli; Mrinali P Gupta; R V Paul Chan; Kimberly A Drenser; Antonio Capone; Timothy G Murray; Shizuo Mukai; Michael T Trese; Audina M Berrocal; Sui Chien Wong; Yoshihiro Yonekawa Journal: Ophthalmic Surg Lasers Imaging Retina Date: 2019-04-01 Impact factor: 1.300
Authors: Roy Schwartz; Sobha Sivaprasad; Rebecca Macphee; Patricia Ibanez; Pearse A Keane; Michel Michaelides; Sui Chien Wong Journal: Retina Date: 2019-12 Impact factor: 4.256