Diagnosis and management of Coats disease from a multimodal perspective

Author: Maria Parra (Colombia)

Co-authors: Juan David Arias, Eduardo J. Viteri

Purpose

To demonstrate the utility of different imaging modalities and therapeutic approaches in the assessment and treatment of Coats disease.

Setting/Venue

International FOSCAL, Floridablanca, Colombia.

Methods

Educative Video. A variety of cases in pediatric and adult patients with Coats disease are discussed. Multimodal imaging using color fundus photography, fundus autofluorescence, fluorescein angiography and swept source optical coherence tomography angiography (SS-OCT-A) are shown. The imaging and clinical response to various treatments is also evaluated in a didactic and educational way.

Results

Patients with Coats and those with related vasoproliferative tumor were treated through distinct treatments. The imaging hallmarks on wide-field fundus photography, fluorescein angiography and macular and peripheral SS-OCTA were exposed showing its changes after the treatment. Specially, an analysis of the characteristics of the periphery is highlighted. The correlation of peripheral and posterior pole images allowed the characterization, monitorization and detection of new vascular abnormalities and their complications. Likewise, differentiating features between pediatric and adult-onset Coats are discussed. Finally, a review of the results after anti-VEGF therapy, steroids, laser photocoagulation, cryotherapy and pars plana vitrectomy (PPV) is done, pointing out the importance of a multidisciplinary combined and continue treatment.

Conlusions

Coats disease must be approached from a multidisciplinary perspective both in its diagnosis and in its treatment. There is no a single successful therapy, instead, the real success in coats lies on the implementation of different targeted treatments throughout the patient's follow-up.

Financial Disclosure

Juan D. Arias: Topcon Consultant.

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