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Table of Contents
LETTER TO THE EDITOR
Year : 2013  |  Volume : 12  |  Issue : 1  |  Page : 61-62  

Coats disease in a Nigerian man with a favorable structural outcome following retinal laser photocoagulation


1 Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
2 Department of Ophthalmology, Ladoke Akintola University Teaching Hospital, Oshogbo, Nigeria

Date of Web Publication7-Mar-2013

Correspondence Address:
Abdulraheem O Mahmoud
P. O. Box - 13834, Ilorin - 240008
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1596-3519.108260

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How to cite this article:
Mahmoud AO, Kolawole O, Ibrahim T, Olokoba L. Coats disease in a Nigerian man with a favorable structural outcome following retinal laser photocoagulation. Ann Afr Med 2013;12:61-2

How to cite this URL:
Mahmoud AO, Kolawole O, Ibrahim T, Olokoba L. Coats disease in a Nigerian man with a favorable structural outcome following retinal laser photocoagulation. Ann Afr Med [serial online] 2013 [cited 2020 Aug 11];12:61-2. Available from: http://www.annalsafrmed.org/text.asp?2013/12/1/61/108260

Sir,

George Coats in 1908 identified this very rare idiopathic retinal telangiectasia with intraretinal or subretinal exudation without appreciable signs of retinal or vitreal traction that typically affects one eye of male children. [1] We wish to share our experience with the first documented case of Coats disease in Nigeria which suggests that the limited nature of retino-vascular abnormalities of the disease in adults make it amenable to retinal laser photocoagulation.

An 18-year-old male presented in March 2011 on account of progressively worsening, painless, poor vision in the right eye of 2 years duration. The associated, past medical and family histories were not remarkable. On examination, his visual acuity was perception of hand movement (HM) in the right eye and 6/6 in the left. There was a leucocoria (white pupil or cat eye reflex) in the right eye [Figure 1]. The anterior segments were quiet and normal bilaterally. A dilated funduscopy revealed extensive yellowish subretinal exudates with a shallow exudative detachment, and telengiactatic vessel infero-temporally in the right [Figure 2]. The left fundus was normal in all respect. He had argon green laser treatment under retro-bulbar local anesthesia, through an indirect ophthalmoscope delivery system.
Figure 1: White pupil or cat eye reflex in the right eye of a Nigerian man with coats disease

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Figure 2: The right fundus picture of a Nigerian man with coat disease before retinal laser treatment

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Both the visual and structural improvements were unimpressive for upwards of 4 months after the initial laser treatment, hence a supplemental retinal laser was carried out in September, 2011, and the sub-retinal fluid completely absorbed afterwards [Figure 3]. The anatomical resolution was, however, unaccompanied by much visual improvement because the yellowish exudates had organized smack on the entire macular [Figure 3].
Figure 3: The right fundus picture of a Nigerian man with coat disease after retinal laser treatment

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The anterior segment was not involved in our patient, just as noted in other climes. [2],[3] Our findings of retinal telengiectasia and retinal exudation in our patient mirror similar findings from a retrospective study of 307 eyes of Indian patients in which nearly all their eyes had retinal telangiectasia in (302, 99%) and exudation in (274, 89%). [2] [Figure 3].

Nucci et al. reported better anatomical benefits from treatment with yellow-dye laser in Coats disease. [4] The diode laser, which is the commonly available one in Nigeria on account of its relative affordability and its demonstrable effectivity in the treatment of a number of retino-vascular conditions in Nigeria, [5] appeared effective in the treatment of our patient.


   Acknowledgement Top


We thank the Orbis International Team which was on a training mission to Ilorin, Nigeria, for allowing us the use of their ophthalmic diagnostic and laser treatment facility inside their Aero plane Flying Eye Hospital during the earlier phase of the management of the patient reported in this study.

 
   References Top

1.Coats G. Forms of retinal disease with massive exudation. R Lond Ophthalmol Hosp Rep 1908;17:440-525.  Back to cited text no. 1
    
2.Rishi P, Rishi E, Uparkar M, Sharma T, Gopal L, Bhende P, et al. Coats' disease: An Indian perspective. Indian J Ophthalmol 2010;58:119-24.  Back to cited text no. 2
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3.Shields JA, Shields CL, Honavar SG, DeMirci H. Clinical variations and complications of Coats' disease in 150 cases: The 2000 Sanford Gifford memorial lecture. Am J Ophthalmol 2001;131:561-71.  Back to cited text no. 3
[PUBMED]    
4.Nucci P, Bandello F, Serafino M, Wilson ME. Selective photocoagulation in Coats disease: Ten-year follow-up. Eur J Ophthalmol 2002;12:501-5.  Back to cited text no. 4
[PUBMED]    
5.Mahmoud AO, Kyari F, Ologunsua Y. Initial experience with the utility of the infrared diode laser in Kaduna, Nigeria. Nig J Ophthalmol 2002;1:37-44.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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