The ophthalmologist participates in the diagnosis and rehabilitation of patients with chiasmal syndrome. Low visual acuity is the most common symptom at presentation, and bitemporal hemianopia the most frequent GVF defect. Examination of the optic nerve head and pupillary responses, and ancillary tests including Ishihara test and neuroimaging are relevant for diagnosis.

Purpose To report clinical findings and final visual acuity outcomes in patients with Coats disease (CD) treated in central Mexico. Methods Retrospective case series analysis of CD patients recruited from five referral hospitals. Clinical characteristics that included age and symptoms at diagnosis, the area of retinal affected, treatment modalities and visual outcomes were recorded. Age of presentation and retinal zones involved were evaluated based on final visual outcomes. Results 67 eyes (66 patients) with diagnosis of CD were identified. Male gender occurred in 81% and the right eye was affected in 55% of the cases. Mean age at diagnosis was 11 years (median 9.8, range 6 months to 65 years). Only 9 patients (13%) had initial visual acuity (VA) better than 1.3 logMAR. Twenty patients received more than one treatment modality and laser photocoagulation was the most widely used. Final VA was classified as blindness in 57 (85%) patients, and it was correlated with worse initial visual acuity (p = 0.005). Number and extension of affected retinal zones were not correlated with age of presentation or gender (p > 0.05). During a mean follow-up of 42 months (SD +/- 37.8), there was slight improvement in visual acuity after treatment in only three cases (4.5%). Conclusion Final visual acuity in almost all CD patients was severe visual impairment. Visual prognosis is poor and depends on stage, location of disease and age of presentation. New strategies for early CD diagnosis by novel methods are needed to improve visual outcomes in these patients.