Increased aqueous lactate dehydrogenase in Coats' disease

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Medical Diagnostics

Background:

• Coats' disease is a rare condition causing abnormal blood vessel development in the retina.
• Glaucoma and retinal detachment can occur alongside Coats' disease, complicating diagnosis.
• Distinguishing Coats' disease from retinoblastoma is critical in pediatric cases.

Observation:

• A 3-year-old boy presented with glaucoma and total retinal detachment with peripheral intraretinal telangiectasis.
• Aqueous humor lactate dehydrogenase (LDH) levels were elevated, three times higher than serum levels.
• Differential diagnosis included Coats' disease and retinoblastoma.

Findings:

• Enucleation confirmed a pathological diagnosis of Coats' disease.
• Elevated aqueous LDH levels were observed in the affected eye.
• The elevated LDH was not indicative of retinoblastoma in this case.

Implications:

• This case highlights the diagnostic challenges in pediatric retinal diseases.
• Aqueous LDH levels require careful interpretation, especially in the presence of glaucoma or inflammation.
• Accurate diagnosis is crucial for appropriate management and visual prognosis in children.