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Schwartz, Roy, MD*; Sivaprasad, Sobha, FRCOphth*; Macphee, Rebecca, BSc*; Ibanez, Patricia, BSc*; Keane, Pearse A., FRCOphth*; Michaelides, Michel, FRCOphth*; Wong, Sui Chien, FRCSEd(Ophth)*,†,‡

doi: 10.1097/IAE.0000000000002322
Original Study: PDF Only

Purpose: To determine vascular change at the macula in both eyes in unilateral pediatric Coats disease using optical coherence tomography angiography.

Methods: Retrospective case-series. Thirteen eyes of pediatric patients with a diagnosis of unilateral Coats disease of various stages were compared with 13 fellow eyes. Optical coherence tomography angiography images were acquired using the RTVue XR Avanti. Scans were analyzed with novel projection artifact removal software and improved segmentation. Vascular density and foveal avascular zone area were calculated.

Results: Vascular density was significantly decreased in eyes with Coats disease in comparison with fellow eyes in both the superficial capillary plexus and deep capillary plexus (43.7 ± 4.7 vs. 45.9 ± 4.4 [P = 0.000] and 43.0 ± 6.3 vs. 50.3 ± 2.2 [P = 0.001], respectively). The difference was also significant for most sectors of the macula. Foveal avascular zone area was significantly larger in eyes with Coats disease in comparison with fellow eyes (0.29 ± 0.1 vs. 0.24 ± 0.09 [P = 0.003]). These significant differences appeared as early as Stage 2A, preceding clinical findings.

Conclusion: The findings support the unilaterality of Coats disease and show that vascular changes on optical coherence tomography angiography precede clinical staging of the condition.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Optical coherence tomography angiography quantitative data in pediatric eyes with unilateral Coats disease found significant differences in vascular density and foveal avascular zone area between disease and fellow eyes that precede clinical signs.

*NIHR Biomedical Research Centre, Moorfields Eye Hospital, UCL Institute of Ophthalmology, London, United Kingdom;

Great Ormond Street Hospital for Children, London, United Kingdom; and

Royal Free Hospital, London, United Kingdom.

Reprint requests: Sui Chien Wong, FRCSEd(Ophth), Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, United Kingdom; e-mail:

Presented at the 5th International Congress on OCT Angiography, “en face” OCT, and advances in OCT, Rome, Italy, December 15, 2017.

Publication of this work was supported by Moorfields Eye Charity. None of the authors has any financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.