Further Evidence Against Bilateral Manifestation Of Coats Disease In Optical Coherence Tomography Angiography of the Macula.

Abstract

Recent studies have questioned the traditional view, which regards Coats disease as a strictly unilateral entity. Applying optical coherence tomography angiography (OCTA), this prospective, monocentric study investigates quantitative capillary changes of the macula associated with Coats disease. 24 eyes (4 untreated, 8 pre-treated) of 12 patients with stage 2 Coats disease (age range: 9 - 61 years) and 15 eyes of healthy, age-matched controls from the University of Muenster Medical Center, Germany received macular OCTA measurements of the superficial (SCP), deep (DCP) and choriocapillary (CC) capillary plexus. Flow density (FD) and parameters related to the foveal avascular zone (FAZ) were compared between Coats eyes and fellow eyes, as well as between fellow eyes and control eyes. Additional subanalyses investigated changes based on disease stage. FD did not differ between fellow eyes of Coats disease patients and control eyes in any of the parameters investigated. Comparison of Coats eyes to their respective fellow eyes revealed Coats disease to be associated with lower FD in SCP, DCP and CC regions, irrespective of disease stage (all p < 0.03). There were no noticeable differences regarding the size or symmetry of the FAZ. In light of the recent discussion around the unilateral character of Coats disease, this trial provides evidence against a bilateral presentation of vascular changes in the macula.