Current management of Coats disease

Surv Ophthalmol. 2014 Jan-Feb;59(1):30-46. doi: 10.1016/j.survophthal.2013.03.007. Epub 2013 Oct 15.

Abstract

Since its original description in 1908, Coats disease has been recognized as an idiopathic cause of severe vision loss with a remarkable diversity in clinical presentation and morphology. Key clinical and imaging variables are helpful in differentiating Coats disease from life-threatening malignancies, and proper management revolves around a thorough knowledge of the differential diagnosis. Despite significant advancement in scientific understanding of the disease process and clinical spectrum, the underlying etiology remains obscure, and both primary and secondary forms are recognized. With the development of anti-VEGF therapy, vitreoretinal specialists have a new, effective adjunct to the clinical management of exudates, macular edema, and serous retinal detachment. We highlight the history, diagnostic challenges, evolving clinical spectrum, and current management of Coats disease.

Keywords: Coats disease; Leber multiple miliary aneurysms; intravitreal bevacizumab; retinal vascular disease; type 1 idiopathic macular telangiectasia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bevacizumab
  • Cryotherapy
  • Diagnosis, Differential
  • Fluorescein Angiography
  • Humans
  • Laser Coagulation
  • Magnetic Resonance Imaging
  • Retinal Telangiectasis / diagnosis*
  • Retinal Telangiectasis / etiology
  • Retinal Telangiectasis / therapy*
  • Tomography, Optical Coherence
  • Ultrasonography
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab