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The detection of COAT’s disease at its early stage and management

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Coats disease is the potential leading cause of blindness which is an idiopathic disorder characterized by progressive deposition of intraretinal or subretinal exudates and abnormal development of retinal vasculatures known as telangiectasia that leads to exudative retinal detachment. The case shows unilateral involvement of the eye and primarily at an early age of 12 years. The cause of the disease is idiopathic and if associated with other genetic disorders emphasizes the deposition of a genetic component. The underlying histopathological problem is thought due to the abnormal permeability of capillary endothelial cells of the retina. The complications of long-standing disease may progress to total retinal detachment, leukocoria, painful Glaucoma and can be hard to differentiate from retinoblastoma. The diagnostic tools are indirect ophthalmoscopy, fluorescein angiography, CT scan, and MRI. The treatment depends on the closure of abnormal leaking vessels of the retina which is laser therapy and anti-VEGF at its early stage. The advanced stage requires surgical therapy such as scleral buckling, pars plana vitrectomy, and anterior vitrectomy for reattachment of the retina or pre retinal membrane. A careful selection therapy showed a 70% improvement in the clinical course of the disease.


Keywords: anti VEGF (vascular endothelial growth factor), exudative retinal detachment, and FFA fundus fluorescein angiography