Coats’ disease of adult‑onset in 48 eyes.
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Date
2016-07
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Abstract
Background: Coats’ disease diagnosed in adulthood is an idiopathic, retinal exudative vascular disease
without an inciting factor and has retinal features different from the childhood disease. Aim: To describe
clinical features, treatment, and outcomes of eyes with Coats’ disease first diagnosed in patients 35 years
or older. Materials and Methods: Retrospective chart review of patients first diagnosed with Coats’
disease at the age of 35 years or more at a tertiary eye care center between January 1995 and 2012. Eyes
with retinal exudation or Coats’‑like response from secondary causes were excluded. Results: Forty‑five
of 646 patients (7%) diagnosed with Coats’ disease had adult‑onset disease. Mean age at presentation
was 47 years. Systemic hypertension was the most common (22%) systemic association and decreased
vision the predominant presenting feature (83%). Localized (<6 clock h) presentation (74%) was unique
to adults as against diffuse involvement (69%) in children (P < 0.001). Eyes were treated with laser
photocoagulation 29 (60%), cryotherapy (4%), or both (2%) with surgical intervention in three (6%)
eyes. Following treatment eight (35%) eyes improved, 11 (48%) eyes were stable while four (12%) eyes
worsened due to complications. Conclusion: Adult‑onset Coats’ disease has less extensive involvement,
more benign natural course, and a more favorable treatment outcome as against the childhood‑onset
disease. The bilateral presentation emphasizes the need for regular follow‑up to detect possible future
involvement of the fellow eye.
Description
Keywords
Adult, Coats’ disease, retina, retinal telangiectasia
Citation
Rishi Ekta, Rishi Pukhraj, Appukuttan Bindu, Uparkar Mahesh, Sharma Tarun, Gopal Lingam. Coats’ disease of adult‑onset in 48 eyes. Indian Journal of Ophthalmology. 2016 July; 64(7): 518-523.