Microincision vitrectomy for secondary epiretinal membrane in adult-onset Coats’ disease

Abstract

We report a case of a 20-year-old male who presented with a gradual painless decrease of vision in his left eye. Best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/200 in the left eye. Anterior segment examination was normal for both eyes. Left eye indirect ophthalmoscopy revealed the presence of a thick epiretinal membrane (ERM) along with telangiectatic vessels and subretinal lipid deposits in inferotemporal quadrant which became more obvious on Fluorescein angiography. Spectral-domain optical coherence tomography (SD-OCT) of left macula revealed a thick ERM with tangential contraction. The patient was diagnosed as adult-onset Coats' disease (Stage 2A) with ERM. The patient underwent standard 25 gauge pars plana vitrectomy with ERM peeling followed by cryotherapy of the telangiectatic vessels. Postoperatively there was a decrease in the amount of subretinal lipid deposition with scarring and obliteration of telangiectatic vessels and BCVA improved to 20/20, N6 which remained stable throughout follow-up.