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Roy Schwartz, Sobha Sivaprasad, Rebecca Macphee, Patricia Ibanez, Pearse Andrew Keane, Michel Michaelides, Sui Chien Wong; Subclinical macular changes and disease laterality in pediatric Coats’ disease determined by quantitative optical coherence tomography angiography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4276.
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© ARVO (1962-2015); The Authors (2016-present)
Coats' disease is mostly considered a unilateral disease and is classified according to the severity of the condition as seen on fundoscopic examination or color fundus photographs, with stage 2B starting to involve the macula. The aim of this retrospective case-series was to determine vascular change at the macula in both eyes in unilateral pediatric Coats’ disease using optical coherence tomography angiography (OCTA), to determine whether there are any suggestions that Coats’ disease is a bilateral disease based on macular findings.
The study included 26 eyes of 13 pediatric patients with a diagnosis of unilateral Coats' disease. Patients with a systemic disease or another retinal pathology were excluded. OCTA images were acquired using a spectral-domain optical coherence tomography angiography device (RTVue XR Avanti) in both eyes. Scans were analyzed with novel projection artifact removal (PAR) software and improved segmentation. Vascular density was calculated at the level of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), and for different macular sectors of these layers. FAZ area was calculated.
Vascular density was significantly decreased in Coats’ eyes in comparison with fellow eyes in both the SCP and DCP (43.7 ± 4.7 vs. 45.9 ± 4.4 (p = 0.000) and 43.0 ± 6.3 vs. 50.3 ± 2.2 (p = 0.001), respectively). The difference was also significant for most sectors of the macula. FAZ area was significantly larger in Coats’ eyes in comparison with fellow eyes (0.29 ± 0.1 vs. 0.24 ± 0.09 (p=0.003)). The significant difference in vascular density and FAZ area appeared as early as stage 2A.
The findings provide evidence that Coats’ disease is a unilateral disease and that vascular changes on OCTA precede clinical staging of the condition.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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