Factors Predictive of Subretinal Fluid Resolution in Coats Disease: Analysis of 177 Eyes in 177 Patients at a Single Center

Abstract

Purpose: The aim of this study was to investigate factors predictive of subretinal fluid (SRF) resolution in Coats disease. Design: Retrospective cohort study. Methods: Institutional review board-approved review of patients diagnosed with Coats disease demonstrating SRF (stage 3–5) at a single center from November 1973 to July 2018 with comparison of eyes that had resolution of SRF to those in which SRF persisted. Results: There were 177 cases (154 males, 87%) of Coats disease diagnosed at a mean age of 8 years. After a mean follow-up of 62 months, SRF resolved in 110 (62%) and persisted in 67 (38%) eyes. Comparison (resolved SRF vs persistent SRF) revealed classification as stage 3A [63 (57%) vs 20 (29%)], stage 3B [47 (43%) vs 40 (60%)], or stage 4 [0 (0%) vs 7 (11%)] ( P < 0.001). Eyes with resolved SRF presented with fewer clock hours of telangiectasia (mean: 5 vs 7 clock hours, P < 0.001), light bulb aneurysms (mean: 5 vs 7 clock hours, P < 0.001), exudation (mean: 7 vs 10 clock hours, P < 0.001), and extent of SRF (mean: 7 vs 10 clock hours, P < 0.001). Factors predictive of SRF resolution included absence of iris neovascularization on fluorescein angiography [odds ratio 0.05 (95% confidence interval 0.01–0.60), P = 0.02], and less elevated SRF by ultrasonography [odds ratio 0.84 (95% confidence interval 0.76–0.95), P = 0.004). For every 1-mm decrease in SRF, likelihood of SRF resolution increased by 16%. Conclusions: Resolution of SRF was achieved in the majority of eyes (62%) with stage 3 to 5 Coats disease. Predictors of SRF resolution included lack of neovascularization on fluorescein angiography and less elevation of SRF by ultrasonography.

Idiopathic Peripheral Retinal Telangiectasia in Adults: A Case Series and Literature Review

“…More advanced stages of IPT involve larger disturbances of retinal morphology and are more difficult to treat. Large reports from the same center provide information on risk factors predictive of persistence of subretinal fluid despite treatment in stages 3-5 [42]. Poor outcome was associated with larger extent of telangiectasias and exudates, larger elevation of subretinal fluid, and the presence of iris neovascularization, and concerned 38% of patients.…”