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Coats disease is a rare abnormality characterized with retinal telangiectasia and aneurysms with retinal exudation, most often seen in young males and usually affecting only one eye. A 12-year-old boy came in with a three-month history of vision loss and pain in his right eye, alongside progressively worsening blurred vision over the last year. His visual acuity was reduced to only light perception in the right eye, while his left eye maintained 5/5 vision. The intraocular pressure was 43.4 mmHg in the right eye and 15 mmHg in the left eye. Conjunctival hyperaemia, mild corneal edema, iris neovascularization, xantocoria, and dilated pupil was found in anterior segment. Ophthalmoscopy showed retinal telangiectasia in all quadrants and total bullous exudative retinal detachment. Coats disease cases that present at an advanced stage have fewer treatment options and generally a worse prognosis.

BackgroundRetinal vessel geometry characteristic have been studied as one of the signs of microvascular changes in diabetic retinopathy (DR) that necessitates early screening. This study aimed to investigate the differences in retinal vessel tortuosity (VT) and fractal dimension (FD) between patients with and without DR.MethodsThis retrospective study analyzed medical records and OCT-A images of DR and No-DR patients. DR severity was graded by a vitreoretinal specialist following the International Clinical Diabetic Retinopathy and Diabetic Macular Edema Severity Scales. Retinal VT and FD were quantified using ImageJ software. Comparison between groups using non-parametric and Generalized Estimating Equations (GEE) statistical analysis combined with cluster bootstrapping.ResultsWe analyzed 96 (161 eyes) with the mean age of 52.7 ± 9.9 years. Compared to No-DR, VT was significantly higher in all DR groups (p < 0.05). Mild non proliferative DR (β = +0.0621), Moderate NPDR (β = +0.0412), Severe NPDR (β = +0.0441), and proliferative DR (β = +0.0404). FD of the superficial capillary plexus (SCP) showed no significant difference among the groups and a significantly lower FD of the deep capillary plexus (DCP) compared to the No-DR groups (moderate NPDR (β = -0.0131), severe NPDR ( β = -0.0316) and PDR ( β = -0.0326)).ConclusionCompared to No-DR group, VT was found significantly higher in DR group, and FD of the DCP found significantly lower in the DR group. These parameters offer unique insights beyond simple vessel loss and complementary information into the geometric complexity and structural alterations of the retinal microvasculature in DR.

Central Retinal Artery Occlusion (CRAO) is a serious ophthalmic emergency characterized by sudden, painless vision loss in one eye. This condition leads to rapid and significant visual impairment if not treated promptly. This case illustrates an adult man with hypertension presented with unilateral, painless, sudden vision loss occurring 13 hours before admission. Examination revealed a visual acuity of 1-meter counting finger in the affected eye, a cherry red spot, and a pale retina. Diagnosed with CRAO, immediate interventions included ocular massage, and acetazolamide loading alongside systemic antihypertensive medication. Visual acuity improved significantly, with the patient able to see 5/30 on the nasal side and can maintain this visual acuity until 6 months follow-up. Immediate and aggressive treatment for CRAO can lead to significant visual recovery even when initiated beyond the traditionally recommended time frame, underscoring the need for quick recognition and intervention in CRAO cases.