577-Nm Yellow Laser Photocoagulation for Coats Disease

Levinson, Joshua D.; Hubbard, G. Baker

doi:10.1097/iae.0000000000000874

Cited by 20 publications

(21 citation statements)

References 15 publications

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“…Coats disease represents a broad clinical spectrum of retinal vasculopathy, predominantly in children, and demonstrating telangiectasia, exudation, retinal detachment, and occasionally neovascular glaucoma or phthisis bulbi. [123456789101112131415161718] The management of Coats disease begins with documentation of the extent of vasculopathy using clinical examination and imaging, particularly with fluorescein angiography. When extensive exudation or retinal detachment is present, Coats disease can simulate malignant retinoblastoma.…”

Section: Discussionmentioning

confidence: 99%

“…However, several authors have demonstrated that this is not the case and laser treatment can be employed for total retinal detachment, as is often seen in the youngest children. [142526]…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, we have noted more sophisticated treatment of Coats disease with vitreoretinal or subretinal/external drainage surgery, laser photocoagulation, and periocular and/or intravitreal medications leading to a reduction in the need for enucleation, especially in advanced-stage Coats disease. [9101112131415161718] Herein, we provide a comprehensive overview of our 45-year experience with Coats disease diagnosis and management. We compare, by decade, the clinical and imaging features, management, and outcomes in 351 consecutive cases based on Coats disease classification.…”

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confidence: 99%

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Coats disease in 351 eyes: Analysis of features and outcomes over 45 years (by decade) at a single center

Shields

Udyaver

Dalvin

et al. 2019

Indian J Ophthalmol

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Purpose: To assess features and outcomes of Coats disease over 5-decades. Methods: Retrospective review of Coats disease patients at a single center. Features and outcomes were compared based on decade of presentation. Results: There were 351 patients with Coats disease. The presenting median age (6 years), male sex (84%), and unilaterality (100%) did not change per decade. Coats disease classification did not change per decade with Stage 1 (1%), Stage 2 (21%), Stage 3 (68%), Stage 4 (6%), and Stage 5 (1%). Clinical features that changed per decade (1970s vs. 1980s vs. 1990s vs. 2000s vs. 2010s) included 1980s features of more eyes with exudation in all 4 quadrants (22% vs. 58% vs. 44% vs. 33% vs. 27, P = 0.01) and total exudative retinal detachment (33% vs. 53% vs. 39% vs. 27% vs. 21%, P < 0.001). Imaging features that changed per decade included 2010s greater fluorescein angiographic extent of retinal non-perfusion in mean clock hours (4 vs. 4 vs. 3 vs. 5 vs. 6, P = 0.003), and 1980s greater mean height of retinal detachment ultrasonographically (5 vs. 12 vs. 5 vs. 5 vs. 4 mm, P < 0.001). Treatment features that changed per decade included 1980s greater primary enucleation (11% vs. 16% vs. 3% vs. 4% vs. 1%, P = 0.001), and 2010s greater use of laser photocoagulation (55% vs. 33% vs. 38% vs. 40% vs. 72%, P < 0.001), sub-Tenon corticosteroid (0% vs. 4% vs. 5% vs. 8% vs. 29%, P < 0.001), and intravitreal anti-VEGF) (0% vs. 4% vs. 2% vs. 13% vs. 18%, P = 0.003). Outcomes that changed per decade included 2010s findings of more complete resolution of subretinal fluid (64% vs. 59% vs. 38% vs. 58% vs. 72%, P = 0.01) and less need for primary/secondary enucleation (17% vs. 27% vs. 14% vs. 13% vs. 6%, P = 0.04). Conclusion: Eyes with Coats disease in the 1980s demonstrated more advanced findings, often requiring enucleation. Over the decades, greater use of laser photocoagulation and injections has led to improved disease resolution with greater globe salvage.

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Section: Discussionmentioning

confidence: 99%

“…However, several authors have demonstrated that this is not the case and laser treatment can be employed for total retinal detachment, as is often seen in the youngest children. [142526]…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Coats disease in 351 eyes: Analysis of features and outcomes over 45 years (by decade) at a single center

Shields

Udyaver

Dalvin

et al. 2019

Indian J Ophthalmol

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“…4,6–8 Longstanding RD in these patients can lead to profound loss of visual acuity. Levinson and Hubbard 9 reviewed the outcomes of 17 cases of Coats disease treated with 577-nm yellow laser photocoagulation of which 8 cases (47%) had RD, classified as “high” (75%) or “low” (25%). A comparison (high vs low RD) regarding visual acuity outcomes revealed 20/50 or better (17% vs 27%), 20/60 to 20/200 (17% vs. 9%), and worse than 20/200 (66% vs 64%) indicating reduced visual prognosis for eyes with high RD.…”

Section: Discussionmentioning

confidence: 99%

“…A comparison (high vs low RD) regarding visual acuity outcomes revealed 20/50 or better (17% vs 27%), 20/60 to 20/200 (17% vs. 9%), and worse than 20/200 (66% vs 64%) indicating reduced visual prognosis for eyes with high RD. 9 Gupta et al 10 in a review of spectral domain optical coherence tomography (SD-OCT) features of 27 cases of Coats disease found macular SRF in 10 eyes (37%), which was associated with worse baseline and final visual acuity. Previous reports from our center 4,6 on the correlation between disease staging and visual outcome found that increasing disease severity was associated with poorer visual outcome (20/200 or worse).…”

Section: Discussionmentioning

confidence: 99%

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

Khoo

Dalvin

Lim

et al. 2019

Asia-Pacific Journal of Ophthalmology

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Purpose: The aim of this study was to investigate factors predictive of subretinal fluid (SRF) resolution in Coats disease. Design: Retrospective cohort study. Methods: 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. Results: 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%. Conclusions: 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.

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Coats Disease

Spandau¹,

Kim²

2019

Pediatric Retinal Vascular Diseases

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577-Nm Yellow Laser Photocoagulation for Coats Disease

Abstract: 577-nm yellow wavelength laser indirect ophthalmoscopy is an effective treatment for Coats disease including cases of exudative retinal detachment.

Cited by 20 publications

References 15 publications

Coats disease in 351 eyes: Analysis of features and outcomes over 45 years (by decade) at a single center

Coats disease in 351 eyes: Analysis of features and outcomes over 45 years (by decade) at a single center

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

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