Coats disease is a non-inherited retinal condition characterised by abnormal, leaky blood vessels that cause lipid-rich exudation and potential retinal detachment. It most commonly affects one eye in young males.
Features
Dilated, telangiectatic retinal vessels leak fluid and lipids into and under the retina, leading to yellow exudates, macular oedema, and in advanced stages exudative retinal detachment. Visual loss depends on the location and extent of exudation.
- Usually unilateral and sporadic with no clear genetic pattern
- Often presents in childhood with decreased vision or a white pupil
- Peripheral telangiectasia may be extensive even when symptoms are mild
- Distinguished from retinoblastoma and other causes of leukocoria by imaging and examination
Management
Treatment targets the abnormal vessels using laser photocoagulation or cryotherapy to reduce leakage and exudation. In more advanced disease, intravitreal therapy or surgery may be required to manage retinal detachment.
- Regular follow-up is necessary because new areas of leakage can develop
- Visual outcome is better when treatment is started before macular damage becomes advanced
- Imaging such as fluorescein angiography helps guide treatment planning
- Support for affected children and families addresses both visual and psychological impacts
