Comments and Conclusions

  • About a 100 years ago, Coat presented a clinicopathologic description of peripheral lesions characterized by massive exudation.1
  • About 50 years later, Reese integrated the Coats lesions with multiple retinal aneurysms as described by Leber and furnished evidence that the “two conditions are one and the same”.2
  • Coats Disease is an idiopathic disorder of abnormal retinal vessel development (telangiectasia) believed to be due to an abnormal permeability of capillary endothelial cells.3
  • Coats is usually found in the first 2 decades of life in young males, most frequently in the temporal retina of only one eye.4
  • Coats occurs in about 1 in 50,000 patients, is bilateral in only about 10% of cases and occurs in women in only about 10% of cases.4
  • Hence, bilateral Coats in a female first discovered in the fourth decade of life (such as our patient) is a very unusual event.
  • Peripheral retinal ischemia with zones of capillary non-perfusion, aneurysmal dilatations and massive exudates are characteristic of Coats.5
  • Some feel that retinal telangiectasias without exudates are characteristic of the early stages of Coats.3