Fig. 4

Case 4. Fovea-involving peripheral Coats disease in a 34-year-old man who slept in the nasal-down position with a flat pillow (inset 1). A A color fundus image obtained when the visual acuity (VA) was 20/100 shows inferotemporal peripheral exudative retinal vascular abnormalities and an exudative retinal detachment recently affecting the fovea. A spectral-domain optical coherence tomography (SD-OCT) image shows a foveal serous detachment. B Four weeks after the initial observation, changing the sleep position to a lateral-down high position (inset 2) and raising the head of the bed resulted in resolution of the foveal detachment. The VA returned to 20/30. C, Four weeks after the first intravitreal injection of Ozurdex, the foveal exudation is coming under control