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Visual acuity outcomes in Coats disease by classification stage in 160 patients
  1. Carol L Shields,
  2. Sanika Udyaver,
  3. Lauren A Dalvin,
  4. Li-Anne S Lim,
  5. Hatice T Atalay,
  6. Chloe Khoo,
  7. Mehdi Mazloumi,
  8. Jerry A Shields
  1. Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Carol L Shields,Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA; carolshields{at}


Purpose To assess visual outcomes of Coats disease by classification stage.

Methods A retrospective review was conducted on consecutive patients with Coats disease, classified according to Shields classification and with available Snellen visual acuity before and after treatment.

Results There were 160 eyes with Coats disease (stage 1 (n=2) vs stage 2A (n=17) vs stage 2B (n=22) vs stage 3A1 (n=26) vs stage 3A2 (n=40) vs stage 3B (n=42) vs stage 4 (n=9) vs stage 5 (n=2)). By comparison, more advanced stage showed greater frequency of poor presenting visual acuity (<20/200) (0% vs 0% vs 50% vs 35% vs 38% vs 83% vs 100% vs 100%, p<0.001) and higher mean intraocular pressure (17 vs 15 vs 15 vs 15 vs 15 vs 15 vs 37 vs 26, p<0.001). More advanced stage was less likely managed with laser photocoagulation (100% vs 87% vs 48% vs 62% vs 74% vs 35% vs 0% vs 0%, p<0.001) and more likely with cryotherapy (0% vs 47% vs 81% vs 81% vs 82% vs 88% vs 50% vs 100%, p=0.001). More advanced stage was associated with lower frequency of visual acuity ≥20/40 (100% vs 71% vs 5% vs 42% vs 23% vs 5% vs 0% vs 0%, p<0.001) and greater frequency of visual acuity <20/200 (0% vs 12% vs 36% vs31 % vs 45% vs 88% vs 0% vs 100%, p<0.001).

Conclusion Visual acuity in eyes with Coats disease parallels staging with more advanced stage demonstrating poorer visual acuity at presentation and final visit.

  • eye
  • retina
  • Coats disease
  • telangiectasia
  • exudation
  • visual acuity

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  • Contributors These authors (CLS, SU, LAD, L-ASL, HTA, CK, MM, JAS) contributed substantially to: the concept, design, acquisition, analysis and interpretation of this work; drafting and revision this work for intellectual content; final approval of the work before publication; agreement to be accountable for all aspects of the work related to accuracy or integrity of any part of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Wills Eye Hospital Institutional Review Board (IRB#19-824E).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.

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