Comparison of Visual Outcomes in Coats' Disease A 20-Year Experience

Purpose: To report differences in visual acuities among patients with Coats' disease who sought treatment at a tertiary care university-based practice. Design: Single-center retrospective cohort study. Participants: Patients with Coats' disease diagnosed clinically, angiographically, or both from 1995 through 2015. Methods: Patients were divided into 2 groups based on date of presentation: decade 1 (1995-2005) and decade 2 (2006-2015). Main Outcome Measures: Visual acuity (VA). Results: Thirty-nine eyes of 39 patients were included with 19 eyes presenting in decade 1 and 20 eyes presenting in decade 2. Three patients demonstrated bilateral disease, but only the worse eye was included for analysis. Forty-seven percent of eyes in decade 1 demonstrated advanced stages of disease (stage 3B or worse) compared with 20% of eyes in decade 2. There was a trend for the mean initial presenting VA (+/- standard deviation) for decade 1 eyes to be worse (2.05 +/- 1.29 logarithm of the minimum angle of resolution [logMAR]) than for decade 2 eyes (1.45 +/- 0.99 logMAR; P = 0.1). From initial to final follow-up visit, mean VA also worsened for decade 1 eyes (P = 0.03), but remained stable for decade 2 eyes (P = 1.0). At the end of follow-up, there was a trend for mean VA for decade 1 eyes (2.28 +/- 1.17 logMAR) to be worse than for decade 2 eyes (1.60 +/- 1.15 logMAR; P = 0.07). Eight eyes were observed initially in decade 1 compared with 1 eye in decade 2, and only 1 of the observed eyes (in decade 2) developed painful glaucoma requiring enucleation. Decade 2 eyes had a higher average number of procedures per eye (6.5 +/- 4.9) compared with decade 1 eyes (1.4 +/- 1.7; P < 0.001). Conclusions: The earlier presentation of disease in decade 2 suggests improvements in disease detection over time. Furthermore, there was a trend for eyes to have better final VA in this decade. This is due to a combination of factors, including earlier presentation of disease, fewer eyes being observed without treatment, and eyes, when treated, receiving a higher number of procedures. (C) 2017 by the American Academy of Ophthalmology