International Consensuses and Guidelines on Diagnosing and Managing Coats Disease by the Academia Retina Internationalis (ARI), the Asia-Pacific Vitreo-retina Society (APVRS), and the Academy of the Asia-Pacific Professors of Ophthalmology (AAPPO)
Issued Date
2026-02-01
Resource Type
ISSN
00029394
eISSN
18791891
Scopus ID
2-s2.0-105023713518
Pubmed ID
41110679
Journal Title
American Journal of Ophthalmology
Volume
282
Start Page
162
End Page
186
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Ophthalmology Vol.282 (2026) , 162-186
Suggested Citation
Mahesh M., Radke N.V., Agrawal R., Balaratnasingam C., Biswas J., Gupta V., Ho M., Kim M., Kumar V., Kusaka S., Lam W.C., Lee V.Y.W., Lu H., Munier F.L., Rojanaporn D., Tsang C.W., Wu W.C., Yonekawa Y., Zhao P., Shanmugam M.P., Lam D.S.C. International Consensuses and Guidelines on Diagnosing and Managing Coats Disease by the Academia Retina Internationalis (ARI), the Asia-Pacific Vitreo-retina Society (APVRS), and the Academy of the Asia-Pacific Professors of Ophthalmology (AAPPO). American Journal of Ophthalmology Vol.282 (2026) , 162-186. 186. doi:10.1016/j.ajo.2025.10.014 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114522
Title
International Consensuses and Guidelines on Diagnosing and Managing Coats Disease by the Academia Retina Internationalis (ARI), the Asia-Pacific Vitreo-retina Society (APVRS), and the Academy of the Asia-Pacific Professors of Ophthalmology (AAPPO)
Author's Affiliation
The University of British Columbia
Chinese University of Hong Kong
Université de Lausanne (UNIL)
Chang Gung Memorial Hospital
Thomas Jefferson University
Postgraduate Institute of Medical Education and Research, Chandigarh
Chang Gung University College of Medicine
Prince of Wales Hospital Hong Kong
Duke-NUS Medical School
Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
The Chinese University of Hong Kong, Shenzhen
Kindai University School of Medicine
Beijing Tongren Hospital, Capital Medical University
Tan Tock Seng Hospital
Lee Kong Chian School of Medicine
Ramathibodi Hospital
Gangnam Severance Hospital
Singapore Eye Research Institute
Dr. Rajendra Prasad Centre for Ophthalmic Sciences
Sankara Nethralaya
University of Western Australia, Centre for Ophthalmology and Visual Science
C-MER (Shenzhen) Dennis Lam Eye Hospital
C-MER Dennis Lam & Partners Eye Center
C+ Health CKJ (Shenzhen) Hospital (D.S.C.L.)
Sankara Eye Hospital
Chinese University of Hong Kong
Université de Lausanne (UNIL)
Chang Gung Memorial Hospital
Thomas Jefferson University
Postgraduate Institute of Medical Education and Research, Chandigarh
Chang Gung University College of Medicine
Prince of Wales Hospital Hong Kong
Duke-NUS Medical School
Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
The Chinese University of Hong Kong, Shenzhen
Kindai University School of Medicine
Beijing Tongren Hospital, Capital Medical University
Tan Tock Seng Hospital
Lee Kong Chian School of Medicine
Ramathibodi Hospital
Gangnam Severance Hospital
Singapore Eye Research Institute
Dr. Rajendra Prasad Centre for Ophthalmic Sciences
Sankara Nethralaya
University of Western Australia, Centre for Ophthalmology and Visual Science
C-MER (Shenzhen) Dennis Lam Eye Hospital
C-MER Dennis Lam & Partners Eye Center
C+ Health CKJ (Shenzhen) Hospital (D.S.C.L.)
Sankara Eye Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
PURPOSE: Coats disease is a rare, retinal vascular disorder characterized by telangiectasias, aneurysmal dilations, and progressive exudative retinal detachment. Limited understanding of the disease warranted the need to identify controversial issues through an extensive literature search and a debate and discussion among international panels of experts. METHODS: Extensive literature search was done on multiple aspects of the disease-classification patterns, disease, Coats-plus, and Coats-like response. Other key factors included the etiology, possible genetic patterns, relationship with other vascular disorders, the role of inflammatory factors and vascular endothelial growth factor (VEGF) in the pathogenesis, diagnostic features, and complications. Considering the varying treatment patterns followed, imaging modalities, clinical findings, differential diagnosis, treatment options, prognostic factors, and emerging concepts in management were all covered in the search. Eighteen experts were included to opine on questions spanning classification, pathogenesis, diagnostic and treatment methods, prognostic controversies, and newer concepts in disease management. RESULTS: Of the 52 questions in 7 sections, the experts arrived at a consensus for 48 (92.3%) statements (with 75% voted as strong agreement or agreement). Most experts agreed on the suggested classification, diagnosis, and prognosis. The controversy, however, remained in questions regarding association with other vascular disorders, treatment of stages 3 and 4, possible benefits of newer anti-VEGF agents, and the role of artificial intelligence. CONCLUSIONS: These debates reflect the rarity of the condition, complex pathophysiology, and the challenges of treating a progressive blinding disease primarily affecting children. Hence, further studies are warranted, especially in areas that have not reached a consensus.