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Vascular findings in primarily affected and fellow eyes of middle-aged patients with Coats’ disease using multimodal imaging
  1. Claudia Brockmann,
  2. Julia Löwen,
  3. Shideh Schönfeld,
  4. Mirjam Rossel-Zemkouo,
  5. Ira Seibel,
  6. Sibylle Winterhalter,
  7. Bert Müller,
  8. Antonia M Joussen
  1. Department of Ophthalmology, Charité Universitatsmedizin Berlin, Berlin, Germany
  1. Correspondence to Claudia Brockmann, Department of Ophthalmology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200 Berlin, Germany, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin 13353, Germany; brockmanncl{at}
  2. Antonia M Joussen Department of Ophthalmology, Charité Universitatsmedizin Berlin, Berlin, Germany; antonia.joussen{at}


Aims To investigate the retinal vascular structure and capillary anomalies of affected and fellow eyes of patients with unilateral Coats’ disease using multimodal imaging.

Methods Clinical investigation of both eyes of each patient with diagnosed Coats’ disease using ultra-widefield (UWF) fundus imaging, including UWF fluorescein angiography (UWFFA), spectral domain optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A).

Results We analysed 38 eyes of 19 patients with unilateral Coats’ disease and found that all fellow eyes (19/19; 100%) revealed vascular alterations, detected by UWFFA, predominantly located in the temporal periphery. Thereby, 89% of the fellow eyes (17/19) presented capillary bed abnormalities, that did not exceed the capillary level; 58% (11/19) presented tortuous abnormalities and 26% (5/19) presented microaneurysmatic abnormalities, exceeding the capillary level. If primarily affected eyes presented central Coats’ specific vascular abnormalities, fellow eyes revealed tortuous vascular abnormalities twice as often (78% (7/9) vs 40% (4/10); P=0.096). In primarily affected eyes, a tendency towards larger foveal avascular zones was revealed, compared to fellow eyes (0.28±0.16 mm2 vs 0.20±0.10 mm2; P=0.123).

Conclusion The use of modern multimodal imaging allows the detection of even subtle vascular changes in fellow eyes of patients with Coats’ disease. Coats’ disease appears to be a bilateral ocular disease with a predominant manifestation in one eye of the affected patients.

  • Child health (paediatrics)
  • Imaging
  • Retina

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  • Contributors CB, AMJ: study design; CB, JL, SS, MR, IS, SW, BM: acquisition, data collection; CB, AMJ: manuscript preparation; CB, IS, SS, AMJ: manuscript revision.

  • 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.

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

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

  • Supplemental material This content has been supplied by the authors. It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the authors and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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