Coats’ disease is an idiopathic exudative retinopathy that is characterized by retinal telangiectasias, aneurysms, and capillary nonperfusion. It is associated with intraretinal and subretinal exudations, which frequently progress to exudative retinal detachment(11 Dorado AM, De-Pablo-Cabrera A, Muñoz-Gallego A, Moreno-García L, Barceló-Mendiguchía A, Tejada-Palacios P. Dexamethasone intravitreal implant as an adjuvant treatment for pediatric patients with Coats’ disease. Arq Bras Oftalmol [Internet]. 2023;86(4):380-3.). Coats’ disease is mostly unilateral and progressive and predominantly affects males during childhood. Although the average age at the time of diagnosis is 8-16 years, adult cases have also been described(22 Shields JA, Shields CL, Honavar SG, Demirci H: Clinical variations and complications of Coats disease in 150 cases: the 2000 Sanford Gifford Memorial Lecture. Am J Ophthalmol. 2001;131:561-71.). The most commonly used classification was proposed by Shields et al., and it is based on funduscopic findings. Although this classification can aid in the disease diagnosis(11 Dorado AM, De-Pablo-Cabrera A, Muñoz-Gallego A, Moreno-García L, Barceló-Mendiguchía A, Tejada-Palacios P. Dexamethasone intravitreal implant as an adjuvant treatment for pediatric patients with Coats’ disease. Arq Bras Oftalmol [Internet]. 2023;86(4):380-3.), in a majority of the patients, some form of ancillary testing, such as fluorescein angiography, ultrasound, computerized tomography, or magnetic resonance imaging, is required(22 Shields JA, Shields CL, Honavar SG, Demirci H: Clinical variations and complications of Coats disease in 150 cases: the 2000 Sanford Gifford Memorial Lecture. Am J Ophthalmol. 2001;131:561-71.). The most common manifestations of the disease are decreased visual acuity, strabismus and leukocoria(33 Ghorbanian S, Jaulim A, Chatziralli IP. Diagnosis and treatment of Coats’ Disease: a review of the literature. Ophthalmologica [Internet]. 2012 [cited 2024 May 24];227(4):175-82.). The differential diagnoses of Coats’ disease include retinoblastoma, retinal vasoproliferative tumor, familial exudative retinopathy, retinal capillary hemangioblastoma, and familial retinal arterial macroaneurysm(11 Dorado AM, De-Pablo-Cabrera A, Muñoz-Gallego A, Moreno-García L, Barceló-Mendiguchía A, Tejada-Palacios P. Dexamethasone intravitreal implant as an adjuvant treatment for pediatric patients with Coats’ disease. Arq Bras Oftalmol [Internet]. 2023;86(4):380-3.). The aim of treatment in Coats’ disease is the ablation of abnormal retinal vasculature, preservation of vision, and prevention of disease progression to retinal detachment(33 Ghorbanian S, Jaulim A, Chatziralli IP. Diagnosis and treatment of Coats’ Disease: a review of the literature. Ophthalmologica [Internet]. 2012 [cited 2024 May 24];227(4):175-82.). Thus, the treatment options include photocoagulation, cryotherapy, and surgery(11 Dorado AM, De-Pablo-Cabrera A, Muñoz-Gallego A, Moreno-García L, Barceló-Mendiguchía A, Tejada-Palacios P. Dexamethasone intravitreal implant as an adjuvant treatment for pediatric patients with Coats’ disease. Arq Bras Oftalmol [Internet]. 2023;86(4):380-3.). Antivascular endothelial growth factor or corticosteroids may also be injected intravitreally as adjuvant therapy(11 Dorado AM, De-Pablo-Cabrera A, Muñoz-Gallego A, Moreno-García L, Barceló-Mendiguchía A, Tejada-Palacios P. Dexamethasone intravitreal implant as an adjuvant treatment for pediatric patients with Coats’ disease. Arq Bras Oftalmol [Internet]. 2023;86(4):380-3.).
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Funding:
This study received no specific financial support.
REFERENCES
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1Dorado AM, De-Pablo-Cabrera A, Muñoz-Gallego A, Moreno-García L, Barceló-Mendiguchía A, Tejada-Palacios P. Dexamethasone intravitreal implant as an adjuvant treatment for pediatric patients with Coats’ disease. Arq Bras Oftalmol [Internet]. 2023;86(4):380-3.
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2Shields JA, Shields CL, Honavar SG, Demirci H: Clinical variations and complications of Coats disease in 150 cases: the 2000 Sanford Gifford Memorial Lecture. Am J Ophthalmol. 2001;131:561-71.
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3Ghorbanian S, Jaulim A, Chatziralli IP. Diagnosis and treatment of Coats’ Disease: a review of the literature. Ophthalmologica [Internet]. 2012 [cited 2024 May 24];227(4):175-82.
Publication Dates
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Publication in this collection
13 Sept 2024 -
Date of issue
2024
History
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Received
16 May 2024 -
Accepted
21 May 2024