Diagnosis Coats' disease

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computed tomography image of patient coats disease, showing total exudative retinal detachment in right eye.


imaging studies such ultrasonography (us), computerized tomography (ct) , magnetic resonance imaging (mri) can aid diagnosis. on ultrasound, coats disease appears hyperechoic mass in posterior vitreous without posterior acoustic shadowing; vitreous , subretinal hemorrhage may observed.


on ct, globe appears hyperdense compared normal vitreous due proteinaceous exudate, may obliterate vitreous space in advanced disease. anterior margin of subretinal exudate enhances contrast. since retina fixed posteriorly @ optic disc, enhancement has v-shaped configuration.


on mri, subretinal exudate shows high signal intensity on both t1- , t2-weighted images. exudate may appear heterogeneous if hemorrhage or fibrosis present. subretinal space not enhance gadolinium contrast. mild moderate linear enhancement may seen between exudate , remaining vitreous. exudate shows large peak @ 1-1.6 ppm on proton mr spectroscopy.


pathologic findings

a case of coats disease, showing total retinal detachment subretinal exudate containing cholesterol crystals , fibrous nodule in posterior pole.


grossly, retinal detachment , yellowish subretinal exudate containing cholesterol crystals commonly seen.



a case of coats disease, showing total exudative retinal detachment, , subretinal exudate containing cholesterol crystals (h&e).


microscopically, wall of retinal vessels may thickened in cases, while in other cases wall may thinned irregular dilatation of lumen. subretinal exudate consists of cholesterol crystals, macrophages laden cholesterol , pigment, erythrocytes, , hemosiderin. granulomatous reaction, induced exudate, may seen retina. portions of retina may develop gliosis response injury.








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