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Alejandra Daruich, Alexandre Matet, Marie-Claire Gaillard, Hoai Viet Tran, Francis L Munier; Extramacular fibrosis in Coats’ disease. Invest. Ophthalmol. Vis. Sci. 2016;57(12):160.
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© 2017 Association for Research in Vision and Ophthalmology.
In Coats’ disease, the terms “vitreoretinal fibrosis”, “proliferative vitreoretinopathy” or “fibrotic vitreoretinopathy have been used to report extramacular fibrosis, a late complication that has been so far poorly characterized but can lead to progressive tractional detachment of the retina and ciliary body. The aim of this study was to determine the rate, risk factors and outcome of extramacular fibrosis in Coats’ disease.
Consecutive cases from a single center were retrospectively reviewed. Clinical characteristics and treatments were analyzed by comparative, multivariate and survival approaches.
Among 69 patients with Coats’ disease, 28 (40.6%) showed evidence of extramacular fibrosis (mean follow-up: 58.2 months). Mean time of fibrosis onset was 17.4 months. Extent of retinal exudation and rate of exudative retinal detachment at baseline were significantly higher in eyes that developed extramacular fibrosis compared to those that did not (P <0.001). Similarly, these parameters showed significant differences using multivariate (p< 0.05) and survival analysis (p<0.001). Extension of telangiectasia, number of cryotherapy or laser sessions, and treatment by anti-VEGF were not associated with extramacular fibrosis. Final visual acuity was worse in patients with extramacular fibrosis (p<0.001). The rates of tractional retinal detachment and macular fibrosis were higher in patients with extramacular fibrosis (39.0% versus 0% and 60.7% versus 19.5%, respectively, p<0.001).
Extramacular fibrosis led to a worse visual prognosis and was associated with the extent of retinal exudation and the presence of exudative retinal detachment at diagnosis. Treatment should target a quick resolution of exudation to limit its development.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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