Coats disease in Saudi Arabia

Abstract

Purpose: : to study the features and treatment outcomes of Coats disease in Saudi Arabia

Methods: : retrospective chart review of patients with Coats disease registered at the King Khaled Eye Specialist Hospital from 1983-2010

Results: : Twenty out of 300 records with the diagnosis of Coats disease were reviewed to date with a follow-up of 4 to 324 months (average 57.6 months). All patients were Middle Eastern. The age ranged from 1 to 44 years (average 14 years). Fourteen cases (70%) were males, and 18 (90%) had unilateral disease. The reason for presentation was decreased vision in 11 cases (55 %), strabismus in 4 (20 %), leukocoria in 2 (10 %), and others in 3 (15 %) . The baseline visual acuity ranged from 20/20 to no light perception . The retinal telangiectasia involved the peripheral fundus in 19 of the 22 eyes (86.4 %) and was restricted to the macular area in 1 eye (4.5 %); involved the temporal fundus in 13 eyes (59.1 %), inferior fundus in 6 eyes (27.3 %), and more than one quadrant in 12 eyes (54.5 %). Retinal exudation was present in 1, 2, 3 and 4 quadrants in 5 eyes (22.7%), 7 (31.8%), 3 (13.6%), and 7 (31.8%) respectively. Foveal exudation was present in 18 eyes (81.8%). The retinal detachment was bullous in 1 eye (4.5%) and shallow in the remaining eyes. Neovascular glaucoma was present in 2 eyes (9%). Fluorescein angiography and ultrasonography showed typically features of Coats disease. The cases could all fit the Shields classification scheme and the most common presentation was stage 3A1 disease (36.4%). Primary management included cryotherapy in 6 eyes (27.3 %), laser photocoagulation in 18 (81.8 %), various methods of retinal detachment surgery in 2 (9 %), intravitreal triamcinolone in 2 (9 %), and combination therapy in 4 (18.2 %). None of the eyes were observed or enucleated. Anatomic improvement/stability was achieved in 45.5 % of eyes with 27.3 % having complete resolution of exudation and subretinal fluid. Final visual acuity was 20/100 or better in 4 eyes (18.2 %), 20/200 to finger counting in 7 (31.8 %), and hand motion to no light perception in 9 (40.9 %).

Conclusions: : Coats disease seen at KKESH has similar clinical characteristics and treatment outcomes as compared to what is reported in the literature in different ethnic populations. This finding suggests the possibility of combining patients with Coats disease across populations to allow for large-scale studies .