Abstract
Purpose :
To study clinical profile, treatment, anatomical and functional outcomes of coats disease managed by a single surgeon
Methods :
Retrospective case series of 83 eyes of 78 patients, diagnosed as coats disease clinically, angiographically or both and treated by a single senior vitreoretinal surgeon in 4 years duration.
Results :
78 patients of coats disease in 4 years period were included in the study.74 patients belong to pediatric age group (less than equal to 16) and 4 were adults. Mean age of presentation was 7.88+/-6.57(36-1)years. Mean age in pediatric population is 6.72+/-4.29 years. 72 males (92.30%) and 6 females (7.70%). Bilateral disease was seen in 5, all were males. Most common symptom was squint (34.66%) followed by incidental finding (19.23%) of coats disease and white reflex (15.38%). Adult onset coats presented with decrease of vision as the chief complaint.11 (13.95%) patients were misdiagnosed, retinoblastoma being the commonest diagnosis (8/11). Commonest stage of presentation was 3b (28/83-33.73%). Adult coats presented with 2a (50%)and 2b(50%). Bilateral disease was asymmetrical. Children less than 5 years presented with more advanced disease. 1 eye presented with cholesterol crystals in the anterior chamber. Treatment was given in the form of laser photocoagulation, cryotherapy, subretinal fluid drainage, scleral buckling and observation depending upon the stage of presentation. 4 patients progressed either with or without treatment. Follow-up visual acuity trend showed stable vision in stage 3a or less whereas 3b and more showed worsening despite anatomical success.
Conclusions :
Early diagnosis and treatment on the basis of clinical staging is pivotal in maintaining visual function. Cryotherapy and Surgical intervention should be reserved for selected cases. Massive exudation with retrolental retina have poorer outcomes despite intervention. Bilateral coats need longer follow up to look out for possible systemic associations.
This is a 2020 ARVO Annual Meeting abstract.