Comparison of Adult and Pediatric Eyes With Coats Disease Using Multimodal Imaging

<b>Purpose:</b> To compare the clinical features, imaging findings, and treatment outcomes between adults and children with Coats disease. <b>Methods:</b> This retrospective, multicenter, observational case series comprised adult and pediatric patients with Coats disease treated between 2016 and 2022. <b>Results:</b> The study included 19 eyes from 10 children and 8 adults. The median age at presentation in children was 6 years (range, 2-17) and in adults was 29 years (range, 24-61). Children presented at later stages of disease compared with adults. The median total clock hours of exudation were greater (2.5 vs 1, <i>P</i> = .01) in children, and macular optical coherence tomography (OCT) findings, including subretinal and intraretinal fluid, were more common (60% vs 11%, <i>P</i> = .03) compared with adults. Children were more likely to present with vessels traversing the foveal avascular zone on OCT angiography (OCTA) (75% vs 29%). At presentation and final follow-up, the visual acuity (VA) was lower in children compared with adults (<i>P</i> ≤ .01). <b>Conclusions:</b> Upon diagnosis with Coats disease, children present at later stages and are more likely to have macular involvement and lower VA compared with their adult counterparts. OCTA showed more qualitative abnormalities in children, while the affected eyes of adults had a lower vessel density of the superficial and deep capillary plexuses compared with their fellow eyes.