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Indian J Ophthalmol. 2016 Jul;64(7):518-23. doi: 10.4103/0301-4738.190141.

Coats' disease of adult-onset in 48 eyes.

Author information

1
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.

Abstract

BACKGROUND:

Coats' disease diagnosed in adulthood is an idiopathic, retinal exudative vascular disease without an inciting factor and has retinal features different from the childhood disease.

AIM:

To describe clinical features, treatment, and outcomes of eyes with Coats' disease first diagnosed in patients 35 years or older.

MATERIALS AND METHODS:

Retrospective chart review of patients first diagnosed with Coats' disease at the age of 35 years or more at a tertiary eye care center between January 1995 and 2012. Eyes with retinal exudation or Coats'-like response from secondary causes were excluded.

RESULTS:

Forty-five of 646 patients (7%) diagnosed with Coats' disease had adult-onset disease. Mean age at presentation was 47 years. Systemic hypertension was the most common (22%) systemic association and decreased vision the predominant presenting feature (83%). Localized (<6 clock h) presentation (74%) was unique to adults as against diffuse involvement (69%) in children (P < 0.001). Eyes were treated with laser photocoagulation 29 (60%), cryotherapy (4%), or both (2%) with surgical intervention in three (6%) eyes. Following treatment eight (35%) eyes improved, 11 (48%) eyes were stable while four (12%) eyes worsened due to complications.

CONCLUSION:

Adult-onset Coats' disease has less extensive involvement, more benign natural course, and a more favorable treatment outcome as against the childhood-onset disease. The bilateral presentation emphasizes the need for regular follow-up to detect possible future involvement of the fellow eye.

PMID:
27609165
PMCID:
PMC5026078
DOI:
10.4103/0301-4738.190141
[Indexed for MEDLINE]
Free PMC Article

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