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Preventable vision loss in children with Coats disease
Francisco Altamirano1, Efren Gonzalez1, Ankoor S Shah1
1Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Insights
Amblyogenic refractive error is common in children with Coats disease, affecting 46% of those with available data. Early diagnosis is key to preventing vision loss.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Genetics
Background:
- Coats disease is a rare condition affecting retinal blood vessels.
- Amblyogenic refractive error can lead to permanent vision impairment if not treated.
Purpose of the Study:
- To determine the prevalence of amblyogenic refractive error in children diagnosed with Coats disease.
- To identify risk factors associated with amblyogenic refractive error in this pediatric population.
Main Methods:
- Retrospective chart review of children under 18 with unilateral Coats disease.
- Data collection included demographics, ocular exams, and treatment history.
- Analysis focused on prevalence and risk factors for amblyogenic refractive error.
Main Results:
- Amblyogenic refractive error was identified in 46% of children with available refractive data.
- Earlier age at diagnosis was associated with a higher likelihood of amblyogenic refractive error.
- Only 50% of children received glasses, and refractions were not consistently performed.
Conclusions:
- Amblyogenic refractive error is a significant concern in children with Coats disease.
- There is a need for better coordination between pediatric and retina specialists.
- Timely diagnosis and management of refractive errors are crucial for optimal visual outcomes.
Purpose:
To describe the prevalence and risk factors associated with amblyogenic refractive error in children with Coats disease.
Methods:
The medical records of children (<18 years of age) with unilateral Coats disease treated at a single tertiary care center were retrospectively reviewed. Data collected included patient demographics, ocular examinations, and treatments. Outcomes included the prevalence and factors associated with amblyogenic refractive error.
Results:
A total of 50 children (82% male) were included; of these, 37 (74%) had refractive data to review. The median age at presentation was 5 years (IQR, 2-10). The Coats disease classification was stage 1 in 1 (2%), stage 2 in 29 (58%), and stage 3 or greater in 20 (40%). Most children (76%) had at least one visit with a pediatric specialist; the rest were only seen by a retina specialist. Among patients with refractive data, amblyogenic refractive error was identified in 46%. Glasses were prescribed to 50% of children. Children diagnosed at an earlier age had increased odds of amblyogenic refractive error (OR = 0.72; 95% CI, 0.57-0.91; P = 0.006) than those diagnosed at an older age.
Conclusions:
Our results suggest that amblyogenic refractive error is prevalent among children with Coats disease, and refractions are not always performed. There is a need to coordinate care between pediatric and retina specialists caring for children with Coats disease to ensure timely diagnosis of amblyogenic refractive error to optimize visual outcomes in this population.
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