Coats Disease With Macular Nodule

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pediatric Ophthalmology

Background:

• Coats disease is a rare condition characterized by retinal telangiectasias and exudation.
• Macular involvement in Coats disease can lead to significant vision impairment.
• Distinguishing Coats disease from other intraocular pathologies is critical for appropriate management.

Purpose of the Study:

• To describe a case series of Coats disease presenting with a macular nodule.
• To highlight the potential of this presentation to mimic retinoblastoma.
• To emphasize the importance of recognizing this rare variant for accurate diagnosis and treatment.

Main Methods:

• Retrospective case series analysis.
• Inclusion of patients with Coats disease and macular nodules.
• Review of clinical presentation, imaging (OCT, USG, FFA), and treatment outcomes.

Main Results:

• Seven patients (2%) with Coats disease and macular nodules were identified, all initially diagnosed as retinoblastoma.
• Macular nodules were typically grayish-white, dome-shaped or bilobed, involving the fovea with surrounding exudates.
• Imaging revealed subretinal nodules with posterior shadowing (OCT) and echodense intraocular nodules (USG), with characteristic fluorescein angiography findings.

Conclusions:

• Macular nodules in Coats disease represent focal lipid accumulation within the macula.
• This rare presentation can closely mimic retinoblastoma, necessitating careful evaluation.
• Awareness of this Coats disease variant is essential for appropriate diagnosis and timely intervention to preserve vision.