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Refining Coats' disease by ultra-widefield imaging and optical coherence tomography angiography.
Graefes Arch Clin Exp Ophthalmol. 2017 Oct; 255(10):1881-1890.GA

Abstract

PURPOSE

The purpose of our study was to describe ultra-widefield (UWF) imaging and optical coherence tomography angiography (OCT-A) findings in affected and fellow eyes of patients with Coats' disease.

METHODS

Consecutive patients affected by Coats' disease were prospectively recruited at the Department of Ophthalmology, San Raffaele Hospital, Milan, Italy in this cross-sectional, observational study. Patients underwent UWF color fundus photographs, UWF green autofluorescence, UWF fluorescein angiography (FA), optical coherence tomography (OCT), with 3 × 3 mm and 6 × 6 mm OCT-A scans of the macula. Images were qualitatively evaluated by two independent operators for the presence of pathology.

RESULTS

Eleven patients affected by Coats' disease (eight males, mean age 17.1 ± 6.7 years). Nine and two patients had a clinical diagnosis of unilateral and bilateral disease, respectively. Five eyes had macular fibrosis. All clinically affected eyes exhibited retinal pathology at UWF imaging with the temporal sector most involved followed by the inferior, nasal, superior and macula. In all eyes with macular fibrosis, OCT-A revealed replacement of the foveal avascular zone with coarse vessels suggestive of vascularized fibrosis and flow void area in the choriocapillaris due to a masking effect; type 3 neovascularization was seen in 75% of cases. Seven out of nine clinically unaffected fellow eyes showed retinal pathology at UWF FA with the temporal quadrant most involved.

CONCLUSION

We demonstrated that Coats' disease is a highly asymmetric bilateral disease and that UWF imaging is able to identify more retinal pathology than standard fundus imaging, thus guiding proper retinal photocoagulation. OCT-A allowed easy identification of type 3 neovascularization in a proportion of patients with macular fibrosis.

Authors+Show Affiliations

Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy. Eye Clinic, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy.Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.Department of Ophthalmology, Santo Spirito Hospital, Casale Monferrato, Alessandria, Italy. Centre for Macular Research, San Mauro Torinese, Turin, Italy.Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy. G. B. Bietti Foundation-IRCCS, Rome, Italy.Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy. giuseppe.querques@hotmail.it.Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28875282

Citation

Rabiolo, Alessandro, et al. "Refining Coats' Disease By Ultra-widefield Imaging and Optical Coherence Tomography Angiography." Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, vol. 255, no. 10, 2017, pp. 1881-1890.
Rabiolo A, Marchese A, Sacconi R, et al. Refining Coats' disease by ultra-widefield imaging and optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol. 2017;255(10):1881-1890.
Rabiolo, A., Marchese, A., Sacconi, R., Cicinelli, M. V., Grosso, A., Querques, L., Querques, G., & Bandello, F. (2017). Refining Coats' disease by ultra-widefield imaging and optical coherence tomography angiography. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, 255(10), 1881-1890. https://doi.org/10.1007/s00417-017-3794-7
Rabiolo A, et al. Refining Coats' Disease By Ultra-widefield Imaging and Optical Coherence Tomography Angiography. Graefes Arch Clin Exp Ophthalmol. 2017;255(10):1881-1890. PubMed PMID: 28875282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Refining Coats' disease by ultra-widefield imaging and optical coherence tomography angiography. AU - Rabiolo,Alessandro, AU - Marchese,Alessandro, AU - Sacconi,Riccardo, AU - Cicinelli,Maria Vittoria, AU - Grosso,Andrea, AU - Querques,Lea, AU - Querques,Giuseppe, AU - Bandello,Francesco, Y1 - 2017/09/05/ PY - 2017/6/29/received PY - 2017/8/28/accepted PY - 2017/8/21/revised PY - 2017/9/7/pubmed PY - 2018/1/11/medline PY - 2017/9/7/entrez KW - Coats’ disease KW - Macular fibrosis KW - Optical coherence tomography KW - Optical coherence tomography angiography KW - Ultra-widefield fluorescein angiography KW - Ultra-widefield imaging SP - 1881 EP - 1890 JF - Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie JO - Graefes Arch Clin Exp Ophthalmol VL - 255 IS - 10 N2 - PURPOSE: The purpose of our study was to describe ultra-widefield (UWF) imaging and optical coherence tomography angiography (OCT-A) findings in affected and fellow eyes of patients with Coats' disease. METHODS: Consecutive patients affected by Coats' disease were prospectively recruited at the Department of Ophthalmology, San Raffaele Hospital, Milan, Italy in this cross-sectional, observational study. Patients underwent UWF color fundus photographs, UWF green autofluorescence, UWF fluorescein angiography (FA), optical coherence tomography (OCT), with 3 × 3 mm and 6 × 6 mm OCT-A scans of the macula. Images were qualitatively evaluated by two independent operators for the presence of pathology. RESULTS: Eleven patients affected by Coats' disease (eight males, mean age 17.1 ± 6.7 years). Nine and two patients had a clinical diagnosis of unilateral and bilateral disease, respectively. Five eyes had macular fibrosis. All clinically affected eyes exhibited retinal pathology at UWF imaging with the temporal sector most involved followed by the inferior, nasal, superior and macula. In all eyes with macular fibrosis, OCT-A revealed replacement of the foveal avascular zone with coarse vessels suggestive of vascularized fibrosis and flow void area in the choriocapillaris due to a masking effect; type 3 neovascularization was seen in 75% of cases. Seven out of nine clinically unaffected fellow eyes showed retinal pathology at UWF FA with the temporal quadrant most involved. CONCLUSION: We demonstrated that Coats' disease is a highly asymmetric bilateral disease and that UWF imaging is able to identify more retinal pathology than standard fundus imaging, thus guiding proper retinal photocoagulation. OCT-A allowed easy identification of type 3 neovascularization in a proportion of patients with macular fibrosis. SN - 1435-702X UR - https://www.unboundmedicine.com/medline/citation/28875282/Refining_Coats'_disease_by_ultra_widefield_imaging_and_optical_coherence_tomography_angiography_ DB - PRIME DP - Unbound Medicine ER -