Retina. 2025 Jun 23. doi: 10.1097/IAE.0000000000004586. Online ahead of print.
ABSTRACT
PURPOSE: To assess observation as first-line management option in early-stage Coats disease.
METHODS: This retrospective study analyzed records of patients diagnosed with Coats disease at a single tertiary pediatric retina center from 2017 to 2025. Patients with Stage 2A or less were included. Clinical data from ophthalmological examination and multimodal retinal imaging were reviewed. Retinal exudation was quantified using wide-field color fundus photographs.
RESULTS: Out of 52 patients with Coats disease, eight with Stage 2A were included (median age: 7.7 years). Mean follow-up duration was 27.5 ± 19.5 months. Mean LogMAR best-corrected visual acuity improved from 0.25 ± 0.55 (∼20/35) at diagnosis to 0.10 ± 0.24 (∼20/25) at the last visit. Seven patients were managed with regular observation as initial option. In these patients, the mean area of exudation decreased from 14.76 ± 14.15 mm2 to 12.24 ± 15.22 mm2, while the mean distance from the macula to the exudation front increased from 6.33 ± 3.38 mm to 6.56 ± 2.56 mm. Five patients showed a reduction in area of retinal exudates and/or an increased distance from the macula. One patient exhibited complete spontaneous regression.
CONCLUSIONS: Most patients with early-stage Coats disease demonstrated stability or minimal progression over follow-up. Regular clinical observation may be a safe and effective initial management strategy in selected Stage ≤ 2A cases, provided close follow-up is maintained.
PMID:40591956 | DOI:10.1097/IAE.0000000000004586
