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Stanga, Paulo E., MD*,†; Romano, Francesco, MD*,‡; Chwiejczak, Katarzyna, MD*; Tsamis, Emmanouil, PhD*,§; Stringa, Francesco, MD*; Biswas, Susmito, MD*,†; Bento, Goncalo, BSc*; Arrigo, Alessandro, MD; Parodi, Maurizio Battaglia, MD; Bandello, Francesco, MD

doi: 10.1097/IAE.0000000000001995
Original Study: PDF Only

Purpose: To assess foveal and parafoveal vasculature at superficial capillary plexus (SCP), deep capillary plexus, and choriocapillaris using optical coherence tomography angiography in the fellow eyes of patients with Coats disease.

Methods: Observational and prospective case series. Thirteen patients with unilateral Coats and 14 healthy age- and sex-matched controls were consecutively recruited at Manchester Royal Eye Hospital and the Department of Ophthalmology of San Raffaele Hospital. Both groups underwent complete ophthalmologic examination, including optical coherence tomography angiography (Topcon Corp) 3 mm × 3 mm scans. Images were imported into ImageJ software and binarized; foveal avascular zone area was manually outlined and vessel density analyzed in inner (foveal) and outer (parafoveal) areas of SCP, deep capillary plexus, and choriocapillaris.

Results: Fellow eyes disclosed a significant increase in the foveal vessel density of SCP (P = 0.04); in particular, superior and temporal quadrants showed more marked alterations (P = 0.02 and 0.04, respectively). Analysis of foveal avascular zone area revealed a significant enlargement in the SCP (P = 0.04). No correlation was found between fellow eyes and the stage of affected eyes.

Conclusion: Fellow eyes of Coats patients carry quantitative foveal vascular alterations at SCP. These may represent markers of altered inner blood–retinal barrier, due to a bilateral defect in midcapillary angiogenesis.

*Manchester Vision Regeneration (MVR) Lab, Manchester Royal Eye Hospital, NIHR/Wellcome Trust Manchester CRF, Manchester, United Kingdom;

Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom;

Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milano, Italy; and

§Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.

Reprint requests: Paulo E. Stanga, MD, Manchester Vision Regeneration (MVR) Lab, Central Manchester University Hospital NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom; e-mail:

P. E. Stanga is a consultant for Allergan Plc, Bausch & Lomb Inc, Bayer AG, Novartis AG, Optos Plc, Second Sight Medical Products, Inc, Topcon Corp, and Carl Zeiss AG. F. Bandello is a consultant for Alcon, Allergan Plc, Famila-Thea, Bayer Schering Pharma AG, Bausch & Lomb Inc, Hoffmann-La-Roche, Novartis, Sanofi-Aventis, and Carl Zeiss AG. The remaining authors have no financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.