Subretinal Fluid Drainage and Vitrectomy Are Helpful in Diagnosing and Treating Eyes with Advanced Coats' Disease

Abstract

Severe forms of Coats' disease are often associated with total retinal detachment, and a differential diagnosis from retinoblastoma is critically important. In such eyes, laser- and/or cryoablation is often ineffective or sometimes impossible to perform. We report a case of advanced Coats' disease in which a rapid pathological examination of subretinal fluid was effective for the diagnosis, and external subretinal drainage combined with vitrectomy was effective in preserving the eye.

Keywords: Coats' disease; Rapid pathological examination; Retinoblastoma; Vitrectomy.

Fig. 1

Anterior segment photograph at the first visit showing a totally detached retina in contact with the posterior surface of the lens. The peripheral retina could not be observed.

Fig. 2

a B-mode echography of the right eye shows a high echo area in the vitreous cavity. b CT shows no evidence of calcification or tumor structure.

Fig. 3

MRIs taken at two different periods. T1 (a) and T2 (b) images taken 3 months before the first visit show a hyperintense lesion and a slightly hypointense lesion in the subretinal space, respectively. Both T1 (c) and T2 (d) images taken at the first visit show hyperintense lesions in the subretinal space. Tumor structure is not observed in the eye.

Fig. 4

Fundus photograph of the right eye during the first operation under perfluoro-n-octane. Dilated retinal vessels, numerous microaneurysms, and intra- and subretinal exudates became visible.

Fig. 5

Fundus photograph of the right eye during the second operation under perfluoro-n-octane. The amount of exudates were reduced.