Coats disease is a congenital retinal vascular disease, which is seen commonly in childhood and remits and exacerbates throughout life. However, it is not rare for coats disease to present in adulthood for the first time. This has been referred to as adult onset coats disease. Fundus findings typical of coats disease included telangiectasis, macular exudation and edema. Fluorescein angiography revealed peripheral capillary nonperfusion areas and telangiectasis.

A year-old male with a history of controlled hypertension and hyperlipidemia presented with a complaint of poor vision in his left eye in excess of 5 years. He denied any changes in his right eye. Anterior segment examination was normal in both eyes and the posterior segment of the right eye was normal. Examination of the posterior segment of the left eye revealed multiple arteriolar macroaneurysms concentrated in the macula and inferior peripheral retina Figure 1a. The macroaneurysms were associated with radiating, dense, intraretinal, and subretinal exudates. At the fovea, the exudates coalesced into a nodule, obliterating the foveal retinal laminations seen on spectral-domain optical coherence tomography SD-OCT Figure 1b. There were associated hemorrhages overlying and surrounding the arterial macroaneurysms.

Correspondence Address : Dr. Coats' disease is a nonhereditary ocular disease, with no systemic manifestation, first described by George Coats in It occurs more commonly in children and has a male predominance. Most patients present clinically with unilateral decrease in vision, strabismus, or leukocoria.

Mean age at presentation was 47 years. The bilateral presentation emphasizes the need for regular follow-up to detect possible future involvement of the fellow eye. Most of the reports exist in the form of isolated case reports or small case series. All methods adhered to the tenets of the Declaration of Helsinki for research involving human subjects. As per the existing institutional policy at the time of the study, Ethics Committee clearance was not deemed necessary at our institute in view of the retrospective nature of the study.