This article is more than 5 years old. Information may no longer be current.
Clinical features may help clinicians distinguish between Coats' disease, retinoblastoma
Click Here to Manage Email Alerts
 Jerry A. Shields |
PHILADELPHIA — Because Coats' disease may often be confused with retinoblastoma, differentiating between the two conditions is important in order to provide better patient care and avoid legal issues, a speaker said here.
"It's important to make the correct clinical diagnosis, recommend proper therapy and avoid medicolegal complication," Jerry A. Shields, MD, said at Macula 2011.
Dr. Shields described a study in which more than 1,600 patients with retinoblastoma and 250 patients with Coats' disease were examined using large fundus drawings, fundus photography, fluorescein angiography and ultrasonography to differentiate between the two conditions.
The investigators found differences in the nature of the pupillary reflex, the color of subretinal fluid, and the caliber and course of retinal blood vessels.
Retinal blood vessels in Coats' disease are irregular, often with aneurysms, and tend to remain visible from the posterior pole to the peripheral fundus, Dr. Shields said.
In cases of Coats' disease, the pupillary reflex and subretinal material are generally yellow in color, whereas retinoblastoma cases are white to gray in color, Dr. Shields said.
Age, gender, family history and laterality may also be helpful in differentiation, although those factors are less reliable, Dr. Shields said.
Retinoblastoma cases have uniformly dilated vessels and disappear into the adjacent neoplasm, he said.
"The anterior chamber is usually clear in both Coats' and retinoblastoma ... but if the anterior chamber is directly involved, you see this glistening cholesterol material in the anterior chamber," Dr. Shields said. "You don't see that in retinoblastoma."
- Disclosure: Jerry A. Shields, MD, has no relevant financial interests to disclose.