1 Q Coats Disease vs Retinoblastoma In one

1 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease.

2 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment

3 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb).

4 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells

5 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells OK, these two things don’t sound anything alike. So why go to the trouble of creating a slide-set comparing and contrasting them?

6 Q/A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells OK, these two things don’t sound anything alike. So why go to the trouble of creating a slide-set comparing and contrasting them? one word Because both are very high on the DDx for leukocoria in the pediatric age group

7 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells OK, these two things don’t sound anything alike. So why go to the trouble of creating a slide-set comparing and contrasting them? Because both are very high on the DDx for leukocoria in the pediatric age group

8 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? -Because both are very high on the DDx for leukocoria in the pediatric -age group --

9 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic Because both are very high on the DDx for leukocoria in the pediatric --Endophytic age group --Diffuse infiltrating

10 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic: Because both are very high on the DDx for leukocoria in the pediatric --Endophytic age group --Diffuse infiltrating

11 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic: Subretinal growth Because both are very high on the DDx for leukocoria in the pediatric --Endophytic age group --Diffuse infiltrating

Coats Disease vs Retinoblastoma Rb: Exophytic type 12

13 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic: Subretinal growth Because both are very high on the DDx for leukocoria in the pediatric --Endophytic: age group --Diffuse infiltrating

14 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic: Subretinal growth Because both are very high on the DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating

Coats Disease vs Retinoblastoma Rb: Endophytic type 15

Coats Disease vs Retinoblastoma Rb: Tumor with both exophytic and endophytic portions 16

17 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic: Subretinal growth Because both are very high on the DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating:

18 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic: Subretinal growth Because both are very high on the DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina

Coats Disease vs Retinoblastoma Rb: Diffuse infiltrating type 19

20 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic? Subretinal growth Because are very high on the DDx for leukocoria in the pediatric Which both form presents --Endophytic? Vertical, into-the-vitreous growth age group with leukocoria? --Diffuse infiltrating? Lateral diffuse growth within the retina

21 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing andpatterns? contrasting them? --Exophytic! Subretinal growth Because are very high on the DDx for leukocoria in the pediatric Which both form presents --Endophytic: Vertical, into-the-vitreous growth age group with leukocoria? --Diffuse infiltrating: Lateral diffuse growth within the retina Exophytic

22 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition is diffuse infiltrating Rb liable to be confused?

23 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition is diffuse infiltrating Rb liable to be confused? Uveitis

24 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition is diffuse infiltrating Rb liable to be confused? Uveitis What is the general term for a condition which mimics uveitis?

25 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition is diffuse infiltrating Rb liable to be confused? Uveitis What is the general term for a condition which mimics uveitis? ‘Masquerade syndrome’

26 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition What is Rb the liable classic is diffuse infiltrating tomanifestation be confused? of diffuse infiltrating Rb that (mis)leads to its diagnosis of uveitis? Uveitis A pseudohypopyon What is the general term for a condition which mimics uveitis? ‘Masquerade syndrome’

27 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition What is Rb the liable classic is diffuse infiltrating tomanifestation be confused? of diffuse infiltrating Rb that (mis)leads to its diagnosis of uveitis? Uveitis A pseudohypopyon What is the general term for a condition which mimics uveitis? ‘Masquerade syndrome’

Coats Disease vs Retinoblastoma Pseudohypopyon in diffuse infiltrating Rb 28

29 Q Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition What is Rb the liable classic is diffuse infiltrating tomanifestation be confused? of diffuse infiltrating Rb that (mis)leads to its diagnosis of uveitis? Uveitis A pseudohypopyon What is the general term for a condition which mimics uveitis? How does thesyndrome’ pseudohypopyon of diffuse infiltrating Rb differ from a true inflammatory hypopyon? ‘Masquerade --Unlike a hypopyon, the pseudohypopyon will shift easily with changes in head position --The pseudohypopyon is snow-white , as opposed to the yellowish tinge of a true hypopyon

30 Q/A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition What is Rb the liable classic is diffuse infiltrating tomanifestation be confused? of diffuse infiltrating Rb that (mis)leads to its diagnosis of uveitis? Uveitis A pseudohypopyon What is the general term for a condition which mimics uveitis? How does thesyndrome’ pseudohypopyon of diffuse infiltrating Rb differ from a true inflammatory hypopyon? ‘Masquerade --Unlike a hypopyon, the pseudohypopyon will shift easily with changes in head position color tinge of a true hypopyon --The pseudohypopyon is snow-white , as opposed to the yellowish

31 A Coats Disease vs Retinoblastoma In one sentence, define Coats disease. A congenital (usually) retinal vascular condition characterized by exudation that can be severe enough to result in massive retinal detachment In one sentence, define retinoblastoma (Rb). A malignant neoplasm of retinal progenitor cells Rb presents as one of three types—what are they called? OK, these two things don’t anything alike. So whyrespective go to thegrowth trouble Thesound types differ with respect to their patterns— what are these of creating a slide-set comparing and patterns? contrasting them? --Exophytic: growth Because both are very high on the Subretinal DDx for leukocoria in the pediatric --Endophytic: Vertical, into-the-vitreous growth age group --Diffuse infiltrating: Lateral diffuse growth within the retina Diffuse infiltrating Rb does not present with leukocoria, and thus will not be confused with Coats. However, it is notorious for being confused with another sort of condition. With what sort of condition What is Rb the liable classic is diffuse infiltrating tomanifestation be confused? of diffuse infiltrating Rb that (mis)leads to its diagnosis of uveitis? Uveitis A pseudohypopyon What is the general term for a condition which mimics uveitis? How does thesyndrome’ pseudohypopyon of diffuse infiltrating Rb differ from a true inflammatory hypopyon? ‘Masquerade --Unlike a hypopyon, the pseudohypopyon will shift easily with changes in head position --The pseudohypopyon is snow-white , as opposed to the yellowish tinge of a true hypopyon

Coats Disease vs Retinoblastoma Pseudohypopyon in diffuse infiltrating Rb Hypopyon in uveitis 32

33 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 5 ? 1 -2 ? Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

34 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

35 Q Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worser? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

36 A Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worser? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

37 Q Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worser? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

38 A Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worser? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

39 Q Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worser? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

40 A Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worser? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

41 Q Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worse? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

42 A Coats Disease vs Retinoblastoma Age (yrs) at presentation Coats Rb 6 -8 1 -2 Sex Maleininadulthood? 75 -85% Can Coats occur % unilateral Yes 75 - 95 M=F 60 What is adult-onset Coats disease called? Only very late in Cataract? It is called ‘adult-onset No Coats disease’ advanced cases Vitreous Frequently No What proportion of Coats’ cases present involvement? (Seeding) in adulthood? Exudate? About 1/3 Yes RD? Yesmilder or worse? Is adult-onset disease Milder b-scan of sub-RD No Yes space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

43 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in? 75 -85% M? =F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

44 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

45 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 ? - 95 ? 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

46 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

47 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? ? No Vitreous involvement? No Only very ? late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

48 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

49 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No ? Only very late in advanced cases Frequently ? (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

50 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

Coats Disease vs Retinoblastoma Rb: Vitreous seeding 51

52 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes ? No ? RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

53 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

54 Coats Disease vs Retinoblastoma Coats disease: Exudation

55 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? ? Yes (retinal detachment) b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

56 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… Sub-RD space empty Calcifications CT reveals… RD RD + Ca 2+

57 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… ? Sub-RD space empty ? Calcifications CT reveals… RD RD + Ca 2+

58 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… No calcifications CT reveals… RD RD + Ca 2+

59 Coats Disease vs Retinoblastoma Rb: Calcifications on b-scan

60 Q Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… No calcifications CT reveals… RD ? RD +? Ca 2+

61 A Coats Disease vs Retinoblastoma Coats Rb Age (yrs) at presentation 6 -8 1 -2 Sex Male in 75 -85% M=F % unilateral 75 - 95 60 Cataract? No Vitreous involvement? No Only very late in advanced cases Frequently (Seeding) Exudate? Yes No RD? Yes b-scan of sub-RD space reveals… No calcifications CT reveals… RD RD + Ca 2+

62 Coats Disease vs Retinoblastoma Rb: Calcifications on CT

OK, quiz time. Is it Coats, or exophytic Rb?

To figure it out, look at the vasculature

In Coats, the retinal vessels are dilated, with microaneurysms and telangiectasias. (Further, the appearance often has a yellow hue. )

In Coats, the retinal vessels are dilated, with microaneurysms and telangiectasias. (Further, the appearance often has a yellow hue. ) Contrast with Rb, in which the retinal vessels are normal in appearance. (And the hue tends to be white. )