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Coats disease can present with a macular nodule, a rare variant that mimics retinoblastoma. Early recognition of this lipid accumulation is crucial for accurate diagnosis and treatment.

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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.