Multimodal imaging may be able to detect even subtle vascular changes in fellow eyes of patients with Coats’ disease, new research published in the British Journal of Ophthalmology suggests. Using ultra-widefield fundus imaging, including fluorescein angiography, OCT and OCT angiography, the research team from Germany found Coats’ disease was a bilateral condition, but with a predominant manifestation in one eye of the affected patients.

The investigation included 38 eyes of 19 patients with unilateral Coats’ disease. Researchers observed all fellow eyes (100%) revealed vascular alterations detected by ultra-widefield fluorescein angiography, predominantly located in the temporal periphery. Additionally, 89% of the fellow eyes presented capillary bed abnormalities that did not exceed the capillary level. The study also found 58% presented with tortuous abnormalities and 26% presented with microaneurysmatic abnormalities that exceeded the capillary level.

In primarily affected eyes that presented with central Coats’ specific vascular abnormalities, fellow eyes revealed tortuous vascular abnormalities twice as often (78% vs. 40%). In primarily affected eyes, the researchers found a tendency toward larger foveal avascular zones compared with fellow eyes (0.28±0.16mm2 vs. 0.20±0.10mm2).

Brockmann C, Löwen J, Schönfeld S, et al. Vascular findings in primarily affected and fellow eyes of middle-aged patients with Coats’ disease using multimodal imaging. Br J Ophthalmol. October 31, 2020. [Epub ahead of print].