Coat's disease: clinical, angiographic, histopathological findings and clinical management

Abstract

Twenty-four consecutive patients with Coats's disease are reported. In 9 cases the blind eye was enucleated because of total exudative detachment of the retina or because of untreatable secondary glaucoma. No treatment had been given. Fifteen patients between 22 months and 52 years of age were managed by argon laser or xenon photocoagulation and/or cryocoagulation. The number of treatment sessions varied from 1 to 9 per patient and totalled 49 sessions. Fluorescein angiography was performed in all cases. In most eyes the arterial system seemed to be more damaged than the venous side. Many arterioles ended in macroaneurysm-like dilatations surrounded by avascular areas or complete vascular closure in more advanced cases. In 11 out of 14 eyes the vision improved after treatment or remained unchanged. The follow-up varied from 1 to 8 years. Persistent and aggressive long-term treatment of Coats's disease is recommended because the prognosis without treatment is poor.