Subfoveal Nodule Affecting Visual Prognosis in Coats' Disease.

PURPOSE: To investigate the characteristics of subfoveal nodules in Korean patients with Coats' disease and their association with visual outcomes Method: A retrospective analysis was conducted within the medical records of patients with Stage 2B or 3A1 Coats' disease, including clinical features, imaging, presence of either a subfoveal nodule or macular fibrosis, and visual outcome.

RESULTS: Twelve patients were present with Stage 2B or 3A1 Coats' disease, and 9 patients (75%) presented with subfoveal nodule. Between the group without subfoveal nodule and the group with subfoveal nodule, there were no significant differences in age (mean, 14.0±1.7 years vs 27.7 ± 21.8, P=0.482), sex (all males), stage of the disease (2B; 3 patients vs 8 patients, P=1.000, 3A1; 0 patient vs 1 patient, P=1.000), extension of retinal exudation (mean 7.7 hours vs 4.1 hours, P=0.209) and peripheral telangiectasia (mean, 3.7 hours vs 4.2 hours, P=0.727), and follow-up duration (mean, 65 months vs 46.1 months, P=0.600). There were significantly more patients with severe visual loss (≤20/200) among the patients with subfoveal nodule (0 patient vs 7 patients, P=0.045), and the cause for severe visual loss was macular fibrosis in all cases. Macular fibrosis developed significantly more frequently in the patients with subfoveal nodule (0 patient vs 7 patients, P=0.045).

CONCLUSION: This study is the first study covering the analysis of subfoveal nodules in Korean patients with Coats' disease. The existence of a subfoveal nodule at the initial diagnosis serves as an indicator predicting the development of macular fibrosis and a less favorable visual outcome in the patients with Coats' disease. A multi-center study with a larger patient pool and further studies toward the therapeutic approach for the subfoveal nodule and macular fibrosis are needed.