Optical coherence tomography angiography and multimodal imaging in the management of coats’ disease

Purpose: To illustrate the spectrum of clinical and imaging features in patients with unilateral Coats’ disease at baseline and in response to treatment with laser, intravitreal bevacizumab, and regional steroids. Observations: Telangiectasias, macular exudates, and vascular leakage were present in all 3 patients included in this series. After treatment with laser and bevacizumab, OCT angiography findings included an anomalous foveal vascular loop and chorioretinal anastomoses. Choroidal flow voids appeared to improve after intravitreal bevaziumab and laser treatment in 2 patients with OCT angiography obtained at follow up. A-scan axial lengths in affected eyes were 1.5–1.8 mm smaller than fellow eyes. Conclusions and importance: OCT angiography is a non-invasive tool that can be a useful adjunct to multimodal imaging studies in the management of Coats’ disease. Improved vascular density following anti-VEGF injection suggests a possible role of the choroidal vasculature in this retinal vascular pathology.