Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Korean J Ophthalmol. 2024 Oct;38(5):413-423. doi: 10.3341/kjo.2024.0100. Epub 2024 Aug 29.
To investigate the retinal vascular abnormalities in both affected and fellow eyes of presumed unilateral Coats disease patients using ultra-widefield fluorescein angiography (UWF-FA) and their association with visual prognosis.
A retrospective review of medical records was conducted on 30 patients diagnosed with presumed unilateral Coats disease, who were evaluated with UWF-FA from March 2003 to May 2024 at a tertiary referral hospital. Clinical features and multimodal imaging findings were evaluated, and factors related to final visual outcomes were analyzed.
All 30 patients were diagnosed with presumed unilateral Coats disease at presentation, comprising 11 childhood-onset (36.7%) and 19 adult-onset patients (63.3%). Retinal vascular telangiectasia was observed in 51.7% of the fellow eyes. The extent of telangiectasia and exudate in the affected eyes did not significantly correlate with the extent of telangiectasia in the fellow eyes. In the more affected eyes, the childhood-onset group had a significantly greater extent of capillary dropout compared to the adult-onset group (5.0 clock hours vs. 2.8 clock hours, p = 0.023). In the fellow eyes, telangiectasia tended to be more frequent in the childhood-onset group, without statistical significance (63.6% vs. 44.4%, p = 0.160). In the multivariable regression analysis, the final best-corrected visual acuity (BCVA) in the more affected eyes was significantly associated with initial BCVA. The mean extent of telangiectasia in the temporal and nasal quadrants (odds ratio, 12.759; p = 0.043) and the initial BCVA of the more affected eyes (odds ratio, 11.841; p = 0.024) were identified as prognostic factors for final moderate to severe visual loss (Snellen BCVA <20 / 66).
About half of the presumed unilateral Coats disease cases exhibited features of the bilateral disease. Visual prognosis is associated with the peripheral retinal telangiectasia in the temporal and nasal quadrants as well as initial BCVA in the affected eyes while it is not associated with retinal vascular abnormalities in the fellow eyes.
通过超广角荧光素血管造影（UWF-FA）研究疑似单侧 Coats 病患者患眼和对侧眼的视网膜血管异常，并探讨其与视力预后的关系。
对 2003 年 3 月至 2024 年 5 月在一家三级转诊医院接受 UWF-FA 检查的 30 例疑似单侧 Coats 病患者的病历进行回顾性分析。评估其临床特征和多模态影像学表现，并分析与最终视力结果相关的因素。
所有 30 例患者在初诊时均被诊断为疑似单侧 Coats 病，其中 11 例为儿童发病（36.7%），19 例为成人发病（63.3%）。51.7%的对侧眼存在视网膜血管扩张。患眼的血管扩张和渗出程度与对侧眼的血管扩张程度无显著相关性。在病变更严重的眼中，儿童发病组的毛细血管闭塞程度明显大于成人发病组（5.0 时钟小时比 2.8 时钟小时，p = 0.023）。在对侧眼中，儿童发病组的血管扩张更为常见，但无统计学意义（63.6%比 44.4%，p = 0.160）。多变量回归分析显示，病变更严重眼的最终最佳矫正视力（BCVA）与初始 BCVA显著相关。病变更严重眼的颞侧和鼻侧象限的血管扩张程度（优势比，12.759；p = 0.043）和病变更严重眼的初始 BCVA（优势比，11.841；p = 0.024）是最终中度至重度视力丧失（Snellen BCVA <20 / 66）的预后因素。
约一半的疑似单侧 Coats 病病例存在双侧疾病的特征。视力预后与颞侧和鼻侧象限的周边视网膜血管扩张以及病变眼的初始 BCVA 相关，而与对侧眼的视网膜血管异常无关。
