A 3-year-old boy is referred for unilateral leukocoria. Examination shows telangiectatic retinal vessels with massive yellowish subretinal exudation and a partial exudative retinal detachment in the right eye. Ultrasonography reveals an exudative mass without calcification. Which feature BEST distinguishes this condition from retinoblastoma?

• A Presence of subretinal exudation
• B Occurrence in a male child
• C Absence of intralesional calcification on imaging ✓
• D Unilateral involvement

Explanation

This is Coats disease, congenital retinal telangiectasia with massive subretinal lipid exudation, typically affecting young boys unilaterally. Both Coats disease and retinoblastoma produce leukocoria with an exudative detachment, so the decisive discriminator is the absence of calcification on C-scan or CT, since calcification is highly characteristic of retinoblastoma. Subretinal exudation, male sex, and unilateral involvement all occur in both conditions and therefore cannot separate them reliably.

Reference: Ryan's Retina, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.