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Special Feature
Dec 2011

Picture of the Month—Diagnosis

Arch Pediatr Adolesc Med. 2011;165(12):1132. doi:10.1001/archpediatrics.2011.190-b

The patient was diagnosed with anterior chamber cholesterolosis secondary to Coats disease. Coats disease is an idiopathic sporadic condition typified by retinal vascular telangiectasia and subretinal lipid exudation, which can lead to secondary retinal detachment. It occurs more commonly in males (76%) and is almost always unilateral (95%).1 Coats disease can occur at any age but the majority of cases are diagnosed in the first 2 decades of life.1 There are no documented systemic associations with classic Coats disease. In the Figure, A and B, the retina is detached and can be seen through the pupil just posterior to the lens. Inferiorly, the characteristic vascular telangiectasia is visible. In this case, the diagnosis of Coats disease was made at the initial presentation based on the presence of vascular telangiectasia and the absence of intraocular calcification.