{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:54:25Z","timestamp":1791561265839,"version":"4.3.4"},"reference-count":83,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Coats disease diagnosed in adulthood is a rare idiopathic retinal telangiectatic vasculopathy that may differ in phenotype from childhood\u2010diagnosed cases. This systematic review synthesizes current evidence to characterize its clinical spectrum, imaging features, treatment outcomes and underlying mechanisms, with a focus on immunovascular pathways. Following\n                    <jats:italic>Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses<\/jats:italic>\n                    (PRISMA 2020) guidelines, PubMed, Scopus and Web of Science were searched through October 2025 for studies including patients \u226518\u2009years with confirmed Coats disease. Clinical and imaging findings, treatment strategies and outcomes were extracted and narratively synthesized. When possible, random\u2010effects meta\u2010analysis was performed. Thirty\u2010five studies comprising 240 patients (250 eyes) were included. Disease presentation was predominantly unilateral and diagnosed at Shields Stage 2 or 3. Laser photocoagulation and anti\u2010vascular endothelial growth factor (VEGF) agents were the most frequently described therapies, with anatomical stabilization or regression of exudation reported in approximately half of treated eyes across heterogeneous studies, and better outcomes in earlier stages. Visual acuity was stabilized or improved in 57.1% of treated eyes, while recurrence occurred in 19.3%. Multimodal imaging consistently identified peripheral telangiectasia, lipid exudation and localized capillary nonperfusion. Aqueous cytokine profiling in small cohorts has reported elevated inflammatory mediators (e.g. interleukin [IL]\u20106 and IL\u20101\u03b2) in some adults, suggesting that inflammatory signalling may contribute to blood\u2013retina barrier dysfunction and macular oedema alongside VEGF\u2010related permeability. Current evidence supports Coats disease diagnosed in adulthood as a chronic telangiectatic retinal vasculopathy with frequent macular involvement. Therapeutic outcomes appear to favour individualized, imaging\u2010guided combination strategies and prospective studies with standardized endpoints are needed to refine management.\n                  <\/jats:p>","DOI":"10.1111\/aos.70149","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:54:33Z","timestamp":1777373673000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Adult\u2010onset Coats disease: A systematic review and meta\u2010analysis of imaging biomarkers and targeted therapies"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3152-542X","authenticated-orcid":false,"given":"Catarina","family":"Francisco","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Unidade Local de Sa\u00fade de Matosinhos  Matosinhos Portugal"},{"name":"PDICSS, Faculty of Medicine Porto University  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisa","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Unidade Local de Sa\u00fade de Matosinhos  Matosinhos Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6737-7932","authenticated-orcid":false,"given":"Camiel J. F.","family":"Boon","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Ophthalmology Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-024-03829-4"},{"key":"e_1_2_9_3_1","article-title":"Three\u2010year results of management of adult\u2010onset Coats' disease by possibly targeting placental growth factor","volume":"12","author":"Alsaggaf 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