Successful outcome of adult-onset Coats’ disease following retinal laser photocoagulation
A 23-year-old male, with no previous medical history, presented to our eye clinic with increasing paracentral scotoma in the right eye of 2 months duration.\nOn examination, best corrected visual acuity (BCVA) was twenty out of twenty (20/20) in both eyes, with normal intraocular pressure. Fundal examination of the right eye showed extensive hard exudates in the superior retina extending close to the fovea []. No abnormalities were seen in the left eye. Fundal fluorescein angiogram (FFA) revealed early hyperfluorescence of telangiectatic, leaking vessels in the superior temporal and nasal regions and hypofluorescence consistent with the subretinal exudates in the right eye. Optical coherence tomography (OCT) showed increased macular thickness. A diagnosis of adult-onset Coats’ disease was considered.\nThe telangiectatic vessels in the superior temporal and nasal retina were treated with direct laser photocoagulation and scatter retinal photocoagulation was applied to the rest of the superior retina. Five months after presentation, the exudates had decreased and there was resolution of the angiomatous changes [Figure and ]. BCVA remained stable at 20/20. There was no recurrence of disease after 3 years of follow-up.