A Case of Coats' Disease of Adult Onset: Rare Association with Prognostic Consequences of Refractoriness

Dibyendu Dhali ； Sukhendu Maiti ； Ranjita Santra (Dhali) ； Radha Krishna Mandal

《Journal of Medical Sciences》 38卷6期 (2018/12) Pp. 280-282

https://doi.org/10.4103/jmedsci.jmedsci_93_17

摘要

Coats' disease is a nonhereditary ocular disease, with no systemic manifestation, first described by George Coats in 1908. It occurs more commonly in children and has a male predominance. Most patients present clinically with unilateral decrease in vision, strabismus, or leukocoria. The most important differential diagnosis is unilateral retinoblastoma, which occurs in the same age group and has some overlapping clinical manifestations. We present a rare case of Coats' disease in an adult with leukocoria. A 37-year-old male presented with dimness of vision with constricted visual field in his left eye for the past 3 months. Ocular examination revealed visual acuity as 6/6 in the right eye and 6/60 in the left eye, which was also same on pinhole correction with leukocoria in the left eye. A fundus examination of the left eye revealed multiple telangiectatic and irregular, dilated aneurysmal retinal vessels, exudative retinal detachment with deep, and extensive subretinal lipid exudates with a well-defined macular edema. Direct fluorescein angiography (DFA) showed early and persistent leakage in the abnormal vessels and hypofluorescence corresponding to the subretinal exudates in the left eye that lead to the confirmation of the diagnosis of Coats' disease. The ocular examination and DFA findings were unremarkable for the right eye. Our report aims to document and illustrate the features of Coats' disease in an adult male, highlights the importance of establishing the correct differential diagnosis, and changes to existing treatment modalities.

關鍵字

Leukocoria ； retinal detachment ； subretinal exudates ； nonhereditary ocular disease