Spectral-domain optical coherence tomography findings in Coats’ disease

Abstract

Purpose : To describe spectral-domain optical coherence tomography (SD-OCT) findings in Coats’ disease and their cross-sectional and longitudinal relationships with best-corrected visual acuity (BCVA)

Methods : 44 eyes of 44 patients with Coats’ disease and SD-OCT imaging from 1/1/2008 to 12/31/2016 were included. At baseline, 21 eyes were treatment-naïve while 23 eyes were previously treated. 27 eyes also had follow up SD-OCTs ≥ 5 months after presentation. SD-OCTs were graded for vitreoretinal interface, retinal and subretinal morphological changes, and retinal thickness was measured at the fovea and macula. These SD-OCT findings were then compared to BCVA.

Results : Baseline macular SD-OCT for treatment-naïve eyes showed intraretinal hyporeflective cystoid spaces (n=13), bright hyperreflectivities most prominently in the Henle fiber layer (n=10) or subretinal space (n=6), epiretinal membrane (n=9), subretinal fluid (n=7), intermediate hyper-reflective nodule (n=5), outer retinal atrophy (n=5) and inner retinal schisis (n=1). On cross-sectional analysis, baseline central subfield SD-OCT findings associated with worse baseline BCVA were as follows: 1) for treatment-naïve eyes – intraretinal bright hyperreflectivities (p=0.02), subretinal bright hyperreflectivities (p=0.01), subretinal fluid (p=0.008), and outer retinal atrophy (p=0.005), as well as increasing foveal total retinal thickness (R²=0.36, p=0.008), central subfield thickness (R²=0.39, p=0.007), and total macular volume (R²=0.75, p<0.0001); and 2) for previously treated eyes – intermediate hyper-reflective nodule (p=0.02) and outer retinal atrophy (p=0.01). Longitudinal analysis of all eyes with follow up revealed baseline SD-OCT features associated with 1) improvement in BCVA at the final follow up – subretinal fluid (p=0.02), intraretinal bright hyperreflectivities (p=0.02) and subretinal bright hyperreflectivities (p=0.048); and 2) poor BCVA at the final follow-up – intermediate hyper-reflective nodule (p=0.03) and outer retinal atrophy (p=0.02).

Conclusions : OCT provides important structural information in the clinical evaluation of Coats’ disease which can help predict visual outcomes after treatment.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Intraretinal bright hyperreflectivities and subretinal fluid (A) resolved after treatment (B) with VA improved from 20/200 to 20/25 but an intermediate hyper-reflective nodule and outer retinal atrophy (C) remained unchanged after treatment (D) with VA stable at 20/400.