Abstract
BackgroundCoats' disease is a non-hereditary ocular disease, with no systemic manifestation, first described by Coats in 1908. It occurs more commonly in children and has a clear male predominance. Most patients present clinically with unilateral decreased vision, strabismus or leukocoria. The most important differential diagnosis is unilateral retinoblastoma, which occurs in the same age group and has some overlapping clinical manifestations.Case presentationA 4 year-old girl presented with a blind and painful right eye. Ocular examination revealed neovascular glaucoma, cataract and posterior synechiae. Although viewing of the fundus was impossible, computed tomography disclosed total exsudative retinal detachment in the affected eye. The eye was enucleated and subsequent histopathological evaluation confirmed the diagnosis of Coats' disease.ConclusionGeneral pathologists usually do not have the opportunity to receive and study specimens from patients with Coats' disease. Coats' disease is one of the most important differential diagnoses of retinoblastoma. Therefore, It is crucial for the pathologist to be familiar with the histopathological features of the former, and distinguish it from the latter.
Highlights
Coats' disease is a non-hereditary ocular disease, with no systemic manifestation, first described by Coats in 1908
The most important differential diagnosis is unilateral retinoblastoma, which occurs in the same age group and has some overlapping clinical manifestations [4]
It is crucial for the pathologist to be familiar with the histopathological features of Coats' disease in order to differentiate it from retinoblastoma
Summary
The exsudative retinal detachment in Coats' disease is caused by leakage of lipoproteic fluid from telangiectasic retinal vessels. Presence of those vessel abnormalities differentiates Coats' disease from other causes of retinal detachment [2]. The list of differential diagnosis of Coat's disease includes retinoblastoma, persistent hyperplastic primary vitreous (PHPV) and toxocariasis. Those diseases can be distinguished based on histopathological findings. Retinoblastoma is the most common primary intraocular malignancy of childhood [7] It is characterized by the presence of cells with round nuclei arranged in cuffs that surrounds retinal vessels [8].
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