Adult-Onset Coats Disease in a 61-Year-Old Woman: A Case Report

Background Coats disease is a rare congenital retinopathy characterized by retinal telangiectasia and exudation, typically affecting young males. Adult-onset cases are uncommon and often present with milder manifestations. Case presentation: A 61-year-old woman presented with a 3-month history of vision loss in her right eye, worsening over 6 days. Examination revealed right-eye visual acuity of 20/40, retinal vessel dilatation, yellowish-white exudation, and shallow retinal detachment in the temporal periphery. Fundus photography, fluorescein angiography, optical coherence tomography (OCT), ultrasound, and magnetic resonance imaging (MRI) confirmed stage 3A Coats disease and bilateral age-related cataracts. Treatment included argon laser photocoagulation and periocular triamcinolone acetonide, followed by intravitreal conbercept injection. Follow-up at 6 months showed reduced exudation, partial retinal reattachment, and improved visual acuity to 20/60, though macular edema persisted. Conclusion Adult-onset Coats disease can present with significant retinal exudation but a favorable prognosis with early intervention. Combined laser and anti-vascular endothelial growth factor (VEGF) therapy may improve outcomes.