Comparison of Adult and Pediatric Eyes With Coats Disease Using Multimodal Imaging

Area of Science:

• Ophthalmology
• Retinal Diseases

Background:

• Coats disease is a rare idiopathic retinal vascular anomaly.
• Understanding age-related differences in Coats disease is crucial for timely diagnosis and management.

Purpose of the Study:

• To compare clinical features, imaging findings, and treatment outcomes in adult versus pediatric patients with Coats disease.
• To identify differences in disease presentation and severity between age groups.

Main Methods:

• Retrospective, multicenter, observational case series.
• Inclusion of adult and pediatric patients diagnosed with Coats disease between 2016 and 2022.
• Analysis of clinical data, optical coherence tomography (OCT), and OCT angiography (OCTA) findings.

Main Results:

• Children (median age 6 years) presented with later disease stages, more exudation, and macular involvement (subretinal/intraretinal fluid) compared to adults (median age 29 years).
• Pediatric patients showed higher rates of foveal avascular zone vessel crossing on OCTA and poorer visual acuity (VA) at presentation and follow-up.
• Adults with Coats disease exhibited reduced superficial and deep capillary plexus vessel density in affected eyes compared to fellow eyes.

Conclusions:

• Children diagnosed with Coats disease typically present with more advanced disease, macular edema, and worse visual acuity than adults.
• OCTA reveals distinct qualitative abnormalities in children and reduced vascular density in adults, underscoring age-specific disease characteristics.