Multimodal imaging study and clinical management in Coats' disease

Abstract

Aims/Purpose: Coats' disease is an idiopathic ocular condition characterized by retinal telangiectasia, aneurysms, and exudation, frequently affects unilateral eyes of young males. Rare pathology of difficult diagnosis and clinical management. Follow‐up by multimodal imaging of clinical improvement after correct treatment in Coats' Disease.Methods: Morales Meseguer University Hospital, Murcia, Spain. Observational study using multimodal imaging of clinical cases in patients diagnosed with Coats' disease. Retrospective follow‐up during several visits between 2021–2023. Images taken with optical coherence tomography (OCT), fluorescein angiography (FA) and autofluorescence.Results: Presentation two clinical cases. A 56‐year‐old female and a 28‐year‐old male diagnosed with Coats disease in right eye. Best corrected visual acuity (BVAC) of 0.6 and 0.5, respectively. Female had macular oedema (ME) with hard exudates in temporal arcade territory with areas of venous and arterial sheathing, macroaneurysm in inferior temporal arcade territory. Hypertrophy of the peripheral retinal pigment epithelium. OCT shows EM, subretinal fluid (SRF) and hyperreflective dots in middle layers. Male with a history of vitrectomy and phacoemulsification after regmatogenous and tractional retinal detachment secondary to the disease, presents pseudophakia, angular synechiae and iridotomies, vascular malformations, inferior haemorrhages, zone of temporal and nasal inferior exudation with FSR area, inferior tear pigmented with laser. OCT shows ME with FSR. Both cases, FA proves blood fluids levels and saccular aneurysms of arterial arterioles and venules. We note an improvement BVAC and EM with resolution of FSR on multimodal imaging study after intravitreal and focal laser treatment.Conclusions: Multimodal imaging in the follow‐up of Coats' disease is essential to assess correct treatment. Treatment with focal laser and intravitreal therapy is safe and effective in control of Coats disease.