Widefield optical coherence tomography angiography of fellow eyes in patients with Coats Disease

PURPOSE: Recent advances in retinal imaging have revealed vasculostructural alterations in fellow eyes of patients with Coats disease, thereby challenging the traditional concept of Coats disease as a strictly unilateral disorder. To further explore the phenotype of this retinal disease, this study investigated whether subclinical vascular changes can be detected in fellow eyes using Widefield Optical Coherence Tomography Angiography (WF-OCT-A). METHODS: This trial prospectively recruited Coats disease patients as well as age- and sex-matched healthy controls from University Hospital Münster. Participants underwent WF-OCT-A imaging, enabling imaging of large peripheral retinal areas. Imaging analysis was carried out using AngioTool. RESULTS: Nineteen patients with Coats disease and nineteen matched healthy controls were included. Quantitative analysis revealed no significant differences in the superficial capillary plexus (SCP) between fellow eyes and control eyes regarding flow density (p = 0.56), number of junctions (p = 0.79), total vessel length (p = 0.61), average vessel length (p = 0.75), number of endpoints (p = 0.96), or lacunarity (p = 0.41). CONCLUSION: In this cohort, WF-OCT-A did not identify detectable retinal vascular alterations in clinically unaffected fellow eyes of patients with Coats disease. This finding argues against previously noted prominent subclinical retinal vascular abnormalities in these eyes.