Factors Predictive of Subretinal Fluid Resolution in Coats Disease: Analysis of 177 Eyes in 177 Patients at a Single Center

• Published in: Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) Vol. 8; no. 4; pp. 290 - 297
• Main Authors: Khoo, Chloe T.L., Dalvin, Lauren A., Lim, Li-Anne S., Mazloumi, Mehdi, Atalay, Hatice T., Udyaver, Sanika, Shields, Jerry A., Shields, Carol L.
• Format: Journal Article
• Language: English
• Published: United States Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology 01-07-2019; Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
• Subjects: Adolescent; Adult; Child; Child, Preschool; Disease Progression; Female; Fluorescein Angiography - methods; Follow-Up Studies; Fundus Oculi; Humans; Infant; Infant, Newborn; Male; Middle Aged; Original Clinical Study; Retina - pathology; Retinal Telangiectasis - diagnosis; Retinal Vessels - pathology; Retrospective Studies; Subretinal Fluid - diagnostic imaging; Time Factors; Tomography, Optical Coherence - methods; Visual Acuity; Young Adult
• ISSN: 2162-0989; 2162-0989
• DOI: 10.1097/APO.0000000000000246

The aim of this study was to investigate factors predictive of subretinal fluid (SRF) resolution in Coats disease.
Retrospective cohort study.
Institutional review board-approved review of patients diagnosed with Coats disease demonstrating SRF (stage 3-5) at a single center from November 1973 to July 2018 with comparison of eyes that had resolution of SRF to those in which SRF persisted.
There were 177 cases (154 males, 87%) of Coats disease diagnosed at a mean age of 8 years. After a mean follow-up of 62 months, SRF resolved in 110 (62%) and persisted in 67 (38%) eyes. Comparison (resolved SRF vs persistent SRF) revealed classification as stage 3A [63 (57%) vs 20 (29%)], stage 3B [47 (43%) vs 40 (60%)], or stage 4 [0 (0%) vs 7 (11%)] (P < 0.001). Eyes with resolved SRF presented with fewer clock hours of telangiectasia (mean: 5 vs 7 clock hours, P < 0.001), light bulb aneurysms (mean: 5 vs 7 clock hours, P < 0.001), exudation (mean: 7 vs 10 clock hours, P < 0.001), and extent of SRF (mean: 7 vs 10 clock hours, P < 0.001). Factors predictive of SRF resolution included absence of iris neovascularization on fluorescein angiography [odds ratio 0.05 (95% confidence interval 0.01-0.60), P = 0.02], and less elevated SRF by ultrasonography [odds ratio 0.84 (95% confidence interval 0.76-0.95), P = 0.004). For every 1-mm decrease in SRF, likelihood of SRF resolution increased by 16%.
Resolution of SRF was achieved in the majority of eyes (62%) with stage 3 to 5 Coats disease. Predictors of SRF resolution included lack of neovascularization on fluorescein angiography and less elevation of SRF by ultrasonography.