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Gupta, Mrinali P., MD*; Dow, Eliot, MD, PhD*; Jeng-Miller, Karen W., MD, MPH; Mukai, Shizuo, MD; Orlin, Anton, MD*; Xu, Kunyong, MD, MHSc*; Yonekawa, Yoshihiro, MD; Chan, R. V. Paul, MD

doi: 10.1097/IAE.0000000000002120
Original Study

Purpose: To evaluate microstructural retinal abnormalities on spectral domain optical coherence tomography (SD-OCT) imaging of eyes with Coats disease.

Methods: This is a multicenter, retrospective study in which SD-OCT images of patients with treatment-naive Coats disease were correlated with clinical examination and visual acuity and, when available, followed longitudinally over time.

Results: Macular SD-OCT of 27 eyes with Coats disease revealed intraretinal edema (59%), intraretinal exudates (67%), subretinal fluid (37%), subretinal exudate (48%), ellipsoid zone disruption (52%), external limiting membrane disruption (41%), and subfoveal nodule (26%). All these microstructural abnormalities correlated with worse baseline and final visual acuities (P < 0.05) on univariate analysis, except for intraretinal edema which exhibited a nonstatistically significant trend toward worse baseline visual acuity (P = 0.16). Within stage 2b eyes, external limiting membrane disruption and subretinal nodule on SD-OCT were associated with worse baseline visual acuity (P = 0.02 for both), and there was a trend toward worse final visual acuity with external limiting membrane disruption and subretinal nodule (P = 0.17 for both) and worse baseline (P = 0.08) and final (P = 0.13) visual acuities with ellipsoid zone disruption. No microstructural abnormalities were noted on OCT of fellow eyes.

Conclusion: Spectral domain OCT can identify microstructural abnormalities in Coats disease that are associated on univariate analysis with worse baseline visual acuity and visual prognosis. Further larger studies are necessary.

In this retrospective, multicenter study, the authors identified microstructural retinal abnormalities of eyes with Coats disease using spectral domain optical coherence tomography imaging and correlated the spectral domain optical coherence tomography findings with Coats disease staging, visual acuity, and visual outcome.

*Department of Ophthalmology, Weill Cornell Medical College, New York, New York;

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; and

Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois.

Reprint requests: Mrinali P. Gupta, MD, Department of Ophthalmology, Weill Cornell Medical College, 1305 York Avenue, 11th Floor, New York, NY 10021; e-mail:

Unrestricted departmental grant from Research to Prevent Blindness (M.P.G., R.V.P.C.); gifts to the Mukai Fund at the Mass Eye and Ear Infirmary (S.M.); National Institute of General Medical Sciences through the Medical Scientist Training Program GM07739 (E.D.); National Institutes of Health R01 EY019474, Bethesda, Maryland (R.V.P.C.); National Science Foundation SCH-1622679, Arlington, Virginia (R.V.P.C.); National Institutes of Health P30 EY001792 Core Grant for Vision Research (R.V.P.C.).

None of the authors has any conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.