Coats’ Disease

Abstract

Coats’ disease is one of the exudative retinopathies, commonly presented in childhood. Differentiation of Coats’ disease from retinoblastoma is vital especially during the first years of life prior to commencing treatment. Early stages of the disease can be controlled with ablative therapies such as laser photocoagulation or cryotherapy; however, as the disease progresses to more advanced stage, transscleral drainage of subretinal fluid (SRF) may be needed to control the disease activity. Transscleral drainage of SRF increases the effectiveness of ablative therapies by attaching the retina. Recently, pars plana vitrectomy has been found useful in advanced Coats’ disease. Removal of vitreous and concomitant vitreoretinal tractional membranes can reduce the need for further ablative treatment and prevent from the development of subsequent tractional retinal detachment. Anti-VEGF agents can be used as an adjunct to ablative therapies in cases where considerable leakage from abnormal vessels is present. Visual prognosis is mainly dependent on foveal involvement. Subfoveal exudation may transform into subfoveal nodule which indicates poor visual prognosis. In advanced disease, visual prognosis is unfortunately quite poor; therefore, the goal of the treatment is to preserve globe anatomically without causing any further disturbance to the patient in such advanced cases. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.