Abstract
Adult-onset Coats disease is an uncommon and vision-threatening disease characterized by the development of abnormal blood vessels in the retina. Coats' disease commonly affects children in the first decade of life, but very rarely manifests in adults after the third decade of life, or who characteristically present with unilateral vision loss. Despite being a sight-threatening disease, the etiology remains inconclusive and various genetic and vascular abnormalities are implicated. Diagnosis relies on ophthalmologic examination, fundus photography, fluorescein angiography, and optical coherence tomography. Treatment modalities include laser photocoagulation, intravitreal injections of anti-vascular endothelial growth factor agents, and, in advanced cases, surgical interventions are needed and the treatment is aimed at avoiding complications like retinal detachment and neovascular glaucoma, which were comparatively rare in adult-onset Coats' disease. Despite therapeutic advancements, the prognosis varies, with some patients experiencing significant visual impairment. This review outlines the clinical features, diagnosis, management, and prognosis of adult-onset Coats' disease, underscoring the importance of early detection and intervention in optimizing visual outcomes.
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