Purchase this article with an account.
L.M. Smithen, G.C. Brown, A.J. Brucker, C.M. Klais, L.A. Yannuzzi, R.F. Spaide; Adult–Onset Coats' Disease . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4048.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To illustrated the manifestations and clinical course of adult–onset Coats’ disease and to describe the characteristics of patients who develop it. Design: Retrospective, observational case series Methods: All patients examined in the authors’ referral practices for Coats’ disease diagnosed after the age of 35 years were identified. Patients with a history of radiation exposure, intraocular inflammation, or of retinal vascular occlusion were excluded. A review of their historical, clinical, and fluorescein angiographic features was performed and the demographic and clinical features of the patients were summarized. Results:There were 12 patients with a mean age at diagnosis of 50 years and a mean follow–up of 6.2 years (range 0 to 17 years). These patients manifested many finding typical of Coats’ disease including unilateral nature of disease (12 of 12 patients), male dominance (12 of 12), vascular telangiectasis, lipid exudation, macular edema, and areas of capillary non–perfusion with adjacent webs of filigree–like capillaries. In the adults, disease was limited to 6 clock hours or less in 9 of 12 patients, did not generally involve the retinal vasculature anterior to the equator, and showed limited potential to expand during the follow–up period. Localized hemorrhage was noted in 9 of 12 patients (75%) almost always near larger aneurismal dilatations. Limited exudative detachment of the retina was seen in 3 eyes and all responded to localized laser photocoagulation. One patient had subretinal fluid seen on OCT that did not require treatment. On average, patients lost 2.1 lines of visual acuity during the follow–up period; 6 patients had a decline in vision, 2 patients had improved vision, and 2 patients had stable vision. No patient had end–stage findings of Coats’ disease such as rubeosis. Conclusions: Coats’ disease can appear in adulthood with retinal vascular abnormalities similar to those seen in younger patients. There are a number of important differences in disease manifestation in adults including limited area of involvement, slower apparent progression of disease, and hemorrhage near larger vascular dilatations.
This PDF is available to Subscribers Only