Atypical presentation of Coats disease.
OBJECTIVE
To highlight the possibility of intraocular calcification in Coats disease and evaluate the ultrasound and computed tomographic findings.


METHODS
A 7.5-year-old boy had a 2-week history of unilateral glaucoma and leukocoria with retinal detachment, suggestive of Coats disease. The possibility of retinoblastoma, however, could not be excluded by ultrasound or computed tomographic examination, which revealed a retinal detachment overlying a subretinal mass with calcification. The blind, painful eye was subsequently enucleated.


RESULTS
Histopathologically, there were telangiectatic retinal vessels in a fold of the detached retina peripherally and proteinaceous exudate in the subretinal space containing cholesterol clefts and foamy histiocytes, characteristic of Coats disease. There was also a fibro-osseous nodule in the macular area that correlated with intraocular calcification clinically.


CONCLUSIONS
This case provides the first documentation of ancillary corroboration of intraocular bone formation in Coats disease, which, although rare, is an important consideration in the differential diagnosis of retinoblastoma.
Department of Ophthalmology, King Khaled Eye Specialist Hospital, Kingdom of Saudi Arabia.
S H
SH
Senft
A A
AA
Hidayat
J C
JC
Cavender
D002114:Calcinosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002648:Child; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000175:diagnosis*; D005901:Glaucoma / Q000175:diagnosis; D006801:Humans; D008297:Male; D011859:Radiography; D012163:Retinal Detachment / Q000175:diagnosis; D012164:Retinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012175:Retinoblastoma / Q000175:diagnosis*; D013684:Telangiectasis / Q000175:diagnosis; D014463:Ultrasonography