Bilateral Coats' Disease: A Case Report

Dae Joong Ma; Jin Choi; Ji Woong Jang; Jeong Hun Kim; Seong Joon Kim; Young Suk Yu

doi:10.3341/jkos.2011.52.1.112

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Ma, Choi, Jang, Kim, Kim, and Yu: Bilateral Coats' Disease: A Case Report

Original Article

J Korean Ophthalmol Soc 2011;52(1):112-116.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.1.112

Bilateral Coats' Disease: A Case Report

Dae Joong Ma, MD¹, Jin Choi, MD¹, Ji Woong Jang, MD¹, Jeong Hun Kim, MD^1,², Seong Joon Kim, MD^1,², Young Suk Yu, MD, PhD^1,²

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

²Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea

Address reprint requests to Young Suk Yu, MD, PhD Department of Ophthalmology, Seoul National University Hospital #28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea Tel: 82-2-2072-2438, Fax: 82-2-741-3187, E-mail: ysyu@snu.ac.kr

Received 11 July 2010 Revised 28 July 2010 Accepted 12 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of bilateral Coats' disease.

Case summary

A 19-month-old boy presented with esodeviation of his eyes, which started 5 months prior. A fundus exam showed total bullous exudative retinal detachment with retinal vascular telangiectasia in the right eye and localized exudative retinal detachment with vascular telangiectasia at the inferior periphery in the right eye. Fluorescein angiogram of the left eye showed retinal telangiectatic vessels, avascular area and fluorescein leakeage from telangiectatic vessels. The patient received external drainage of subretinal fluid and intravitreal air injection of the right eye and Argon LASER photocoagulation and cryotheraphy of the left eye. A cytologic exam of the subretinal fluid drained from the right eye showed no malignant cells. Forty-four months after the operation, his best corrected visual acuity was no light perception in the right eye and 0.4 in the left eye. Both fundi were flat and stable. No complications, such as glaucoma, recurred retinal detachment, or pain, occurred.

Conclusions

Coats' disease rarely occurs bilaterally and can be involved asymmetrically. The disease presents more severely when bilateral and can progress after long-term observation. Proper treatment and long-term follow-up of both eyes are necessary to prevent visual loss and preserve eyes.

Keywords: Coats' disease, Exudative retinal detachement, Retinal telangiectasia

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Figure 1.

Initial examination findings. (A) Total bullous exudative retinal detatchment with retinal vascular telangiectasia in the right eye. (B) Fundus photograph showing characteristic features of Coats' disease with localized exudative retinal detachment with vascular telangiectasia at the inferior periphery in the left eye. (C) Ocular ultrasonography showing no mass-like lesion. (D) Orbit CT showing no mass-like lesion.

Figure 2.

Fluorescein angiogram of the left eye before the laser photocoagulation. (A) Retinal telangiectatic vessels and avascular area. (B) Fluorescein leakeage from telangiectatic vessels.

Figure 3.

Fundus photograph taken 2 months after operation. (A) Right eye, flat. (B) Left eye, subretinal fluid decreased a great deal.

Figure 4.

Fundus photograph taken 33 months after operation. (A) Right eye. (B) Left eye. Both fundi are flat and stable.

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