Abstract
Purpose :
To investigate predictors of retinal detachment (RD) resolution in Coats disease.
Methods :
We performed a retrospective review of all patients diagnosed with Coats disease stage 3 to 5 with RD at a single center from November 1973 – July 2018. We compared characteristics of eyes that had resolution of RD to those in which RD did not resolve using Student’s t-test and Chi-Square test. Binomial logistic regression was used to adjust for possible confounders.
Results :
There were 187 eyes from 184 patients (161 males, 86%) with stage 3 to 5 Coats disease. Mean age at presentation was 8 years (median 4, range 0-60 years), with unilateral disease in 177 patients (96%). After mean follow-up of 65 months (median 35, range 0-392 months), RD resolved in 114 (61%) and persisted in 73 (39%) eyes. Comparing eyes (resolved RD versus (vs.) persistent RD), eyes were classified as Stage 3A (66 (58%) vs. 23 (31%)), as Stage 3B (48 (42%) vs. 42 (58%)), or Stage 4 (0 (0%) vs. 8 (11%)) (p<0.001). There was no Stage 5 disease in either group. Eyes with resolved RD were less likely to have light bulb aneurysms in 3 or more quadrants (28 (25%) vs. 31 (42%), p<0.001), exudation in 3 or more quadrants (56 (49%) vs. 55 (76%), p<0.001), or subretinal fluid (SRF) in 3 or more quadrants (56 (49%) vs. 60 (82%), p<0.001). On adjusted analysis, factors predictive of persistent RD included: increasing SRF thickness by ultrasonography (OR 0.82, p=0.04) with 18% decreased probability for RD resolution per each 1 mm increase in SRF; increasing telangiectasia extent in clock hours by fluorescein angiography (FA) (OR 0.53, p=0.02) with 47% decreased probability for RD resolution per each increase in one clock hour; and increasing total number of treatments received (OR 1.36, p=0.03) with 36% increased probability for RD resolution per each additional required treatment.
Conclusions :
Resolution of RD was achieved in the majority of eyes (61%) with stage 3 to 5 Coats disease. Predictors of resolution of RD include less SRF measurement by ultrasound and less telangiectasia extent in clock hours by FA.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.