A 22-year-old man presented with progressive blurred vision for 6 months in the left eye. He had no history of systemic disease, premature birth, ocular trauma, or surgery. Visual acuity was 20/20 OD and 20/400 OS. Results from slitlamp biomicroscopic examination and intraocular pressure were normal.
Fundus examination showed extensive exudative lipid deposition over the posterior pole and periphery (Figure, A). There were multiple macroaneurysms in the nasal peripheral retina. Other findings included fusiform arteriolar dilatation (light bulb aneurysms), venous macroaneurysms, and circinate exudates over the temporal macula and superior and inferior vascular arcades. Ultra-widefield fluorescein angiography revealed marked telangiectatic vessels, nonperfusion, and multiple large retinal arterial and venous aneurysms with leakage (Figure, B). He was diagnosed as having Coats disease and treated with retinal laser photocoagulation and intravitreal anti–vascular endothelial growth factor.
Chen K, Wang N, Wu W. Coats Disease in a Young Adult Man. JAMA Ophthalmol. 2018;136(12):e183146. doi:10.1001/jamaophthalmol.2018.3146
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