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Reemergence of dormant Coats disease after 30 years.
[coats disease]
We
describe
an
atypical
case
of
a
patient
with
Coats
disease
that
re
-emerged
after
30
years
,
illustrating
a
previously
poorly
understood
long
-term
evolution
of
the
disease
.
A
20
-
year
-old
man
consulted
for
visual
acuity
(
VA
)
decrease
in
the
left
eye
(
LE
)
to
0
.
3
.
Fundus
examination
revealed
an
exudative
lesion
with
telangiectasias
in
the
superior
peripheral
retina
compatible
with
the
diagnosis
of
Coats
disease
.
The
patient
was
treated
with
cryotherapy
and
argon
laser
.
Visual
acuity
improved
to
0
.
5
and
remained
stable
during
a
1
-
year
follow-up
.
The
patient
did
not
seek
further
clinical
follow-up
.
Thirty
years
later
,
he
returned
complaining
of
a
progressive
VA
decrease
in
the
LE
.
Snellen
VA
was
measured
to
counting
fingers
.
Fundus
examination
revealed
stage
3
A
Coats
disease
with
macular
exudation
and
a
serous
retinal
detachment
in
the
inferior
quadrants
requiring
the
placement
of
an
encircling
band
,
external
drainage
,
and
cryotherapy
of
the
vascular
lesions
.
After
10
additional
sessions
of
argon
laser
on
the
vascular
malformations
,
exudation
regressed
further
and
best-corrected
VA
increased
to
0
.
1
at
the
end
of
the
follow-up
period
.
Coats
disease
must
be
considered
as
a
chronic
disease
,
which
necessitates
a
very
long
-term
follow-up
even
in
the
absence
of
subjective
visual
loss
.
The
disease
can
reawaken
and
recur
with
force
in
previously
unaffected
areas
of
the
retina
several
decades
later
.
The
gold
standard
treatment
consists
of
cryotherapy
and
argon
laser
.
However
,
in
cases
of
very
important
retinal
exudation
,
surgical
management
with
subretinal
drainage
may
be
necessary
.
Diseases
Validation
Diseases presenting
"vascular malformations"
symptom
coats disease
cowden syndrome
focal myositis
proteus syndrome
pyomyositis
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