Title

LASER TREATMENT IN AN EXTENSIVE COATS DISEASE CASE IN A YOUNG FEMALE

Introduction

To present a case of laser treatment in Coats disease in a female children with extensive exudation

Methods

This is a case report of a patient examined at the Centro Oftalmológico de Minas Gerais on May 2019.

Results

The patient is a 15 year old female with worsened vision for about 30 days in the right eye (OD). Visual acuity was 20/400. The retinal exam presented with an extensive macular exudation associated with hemorrhage and vascular abnormalities in the macular area and temporal periphery. Wide-field fluorescein angiography presented with multiple vascular dilation, ischemic áreas and exudation. Optic coherence tomography became evident the extensive intraretinal exudation. Laser photocoagulation was then performed with visual improvement and less exudation.

Discussion

Coats disease (CD) is a congenital and idiopathic condition most frequent in male children. It presents with retinal telangiectasia and exudation. Our patient was a female children, what is not usual. Sorologic exams were performed to discard other exsudation causes. The natural history of the disease is the lipoprotein leakage that can evolve with retinal detachment. Our patient had evolved to a large macular intraretinal exudation, but without retinal detachment. Treatment is necessary to eliminate telangiectasias leading to improvement of the exudation and preventing neovascular glaucoma. Therapeutic options include crioteraphy, photocoagulation and vitrectomy. In this case the retina was attached, so we decided to treat with laser photocoagulation and succeeded. Althought CS having a poor visual outcome, it’s important to reduce complications, and our patient had also visual quality improvement.

Keywords

Retinal Telangiectasis, Laser Coagulation, Ultra-wide field angiography

Area

CLINICAL CASE

Authors

NADIA CAROLINA LIMA LIMA, CARLOS GUSTAVO LEITE VIEIRA, VINICIUS CARRIERO LIMA