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Abstract
Purpose: To assess the demographic and treatment features of pediatric patients of Coats' disease with retinal cyst using wide-angle FA.Design: A retrospective, hospital based, cross-sectional study.Participants: Pediatric patients of Coats' disease underwent wide-angle FA.Methods: A retrospective review of pediatric patients of Coats' disease who underwent wide-angle FA at a single center from January 2015 to July 2020. Demographic and treatment features were compared between patients with or without retinal cyst.Main Outcome Measures: Demographic and treatment outcomes.Results: There were 123 pediatric Coats' patients in our study, and 18.70% (23/123) of the patients developed complications with retinal cyst, 73.9% (17/23) of the retinal cysts were located in the inferior-temporal quadrant and 82.6% (19/23) of the retinal cysts were located in the peripheral retina anterior to the vortex veins. Compared with patients without retinal cyst, patients with retinal cyst had more clock-hours of telangiectasia on FA (7.32 vs. 5.41, p = 0.031), and may need more total treatments (7.47 vs. 3.53, p = 0.023) including laser photocoagulation (4.08 vs. 2.31, p = 0.019) or intravitreal anti-VEGF (3.13 vs. 2.23, p = 0.039), and also required a longer time for telangiectasia resolution (22.33 vs. 18.53 months, p = 0.043).Conclusion: Pediatric patients with Coats' disease complicated by retinal cyst presented with more clock-hours of telangiectasia on FA and needed more total treatments and longer time for telangiectasia resolution.
Highlights
Coats’ disease is a congenital, idiopathic retinal telangiectasia characterized by intraretinal and/or subretinal exudation leading to progressive exudative retinal detachment without retinal or vitreous traction [1, 2]
We hereby retrospectively reviewed a case series of pediatric Coats’ disease and gave a descriptive analysis of pediatric Coats’ disease complicated with retinal cyst, using RetCam III imaging combined with wide-angle fluorescence angiography (FA)
Statistical analysis revealed no significant difference in presenting age, sex, affected eye (Table 1), preoperative visual acuity, Coats’ disease stages and macular involvement between the two groups, but FA showed more clock hours of telangiectasia in the group of patients with retinal cyst compared with cases
Summary
Coats’ disease is a congenital, idiopathic retinal telangiectasia characterized by intraretinal and/or subretinal exudation leading to progressive exudative retinal detachment without retinal or vitreous traction [1, 2]. It remains a great challenge of diagnosis and treatment because of its varied clinical presentation, and the majority of the cases present with advanced stages ending with poor visual acuity prognosis in spite of aggressive treatment [3, 4]. There are a few reports about Coats’ disease complicated with retinal cyst, but these have either been single cases or have given few details of its clinical and treatment features [7, 8].
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