A 6-year-old boy is referred for unilateral leukocoria. Examination shows a yellowish exudative retinal detachment with telangiectatic retinal vessels and subretinal lipid exudation. B-scan ultrasound shows no calcification. What is the most likely diagnosis?
- A Coats disease ✓
- B Retinoblastoma
- C Persistent fetal vasculature
- D Toxocariasis
Correct answer: A. Coats disease
Explanation
Coats disease is an idiopathic retinal telangiectasia with massive subretinal exudation, typically unilateral, affecting boys around 4 to 10 years of age, and it is an important simulator of retinoblastoma in the differential of leukocoria. The absence of calcification on ultrasound is the single most useful finding against retinoblastoma, since calcification is present in the vast majority of retinoblastomas. Persistent fetal vasculature presents earlier with a microphthalmic eye and a retrolental fibrovascular stalk.
Reference: Ryan's Retina, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.