Macular Features on Spectral-Domain Optical Coherence Tomography Imaging Associated With Visual Acuity in Coats' Disease

PURPOSE: To investigate the association between macular features on spectral-domain optical coherence tomography (SD-OCT) and visual acuity (VA) in Coats' disease. METHODS: Thirty-nine eyes (39 patients) with SD-OCT from January 1, 2008 to December 31, 2016 were reviewed for SD-OCT features. Central subfield (CSF) SD-OCT findings were analyzed relative to VA (logarithm of the minimum angle of resolution) at baseline and final visit (when follow-up ≥ 6 months) and across visits. RESULTS: Mean VA ± standard deviation at baseline (37 eyes) was 0.92 ± 0.82. SD-OCT features associated with worse VA included, for treatment-naïve eyes (n = 21), outer retinal atrophy (ORA) (1.18 ± 0.34 with versus 0.20 ± 0.30 without, P = 0.005), subretinal fluid (SRF) (1.80 ± 0.63 vs. 0.63 ± 0.50, P = 0.008), bright hyperreflectivities (1.23 ± 0.68 vs. 0.52 ± 0.53, P = 0.02), thicker foveal subretinal space (r(2) = 0.32, P = 0.01), and CSF (r(2) = 0.39, P = 0.007); and for previously treated eyes (n = 16), a compact hyperreflective structure (1.60 ± 0.88 vs. 0.56 ± 0.64, P = 0.02) and ORA (1.34 ± 0.86 vs. 0.30 ± 0.44, P = 0.01). At final follow-up (n = 22), mean VA was 0.81 ± 0.83. Eyes with final VA <20/200 (n = 6, vs. >20/60, n = 11) more commonly had a compact hyperreflective structure and ORA at baseline and final visit (P < 0.05). Mean change in VA from baseline (n = 20) was −0.20 ± 0.59. Mean improvement in VA (range, −0.525 to −1.127) occurred in eyes with baseline SRF (P = 0.02) and bright hyperreflectivities (P = 0.03). Changes in thickness that correlated with change in VA included those for the foveal subretinal space (r(2) = 0.52, P < 0.001) and CSF (r(2) = 0.26, P = 0.045). CONCLUSIONS: A compact hyperreflective structure (fibrosis) and ORA were associated with poor final VA while SRF, bright hyperreflectivities (exudation), and foveal subretinal thickness were associated with VA improvement post treatment.