PEARLS AND PITFALLS IN DIAGNOSIS AND MANAGEMENT OF COATS DISEASE

In Brief Purpose: To review current literature on Coats disease and provide a structured framework for differentiating challenging clinical features in Coats disease patients. Methods: We critically reappraise historical and current literature and present clinical methods for developing a thorough differential diagnosis and management strategy for Coats disease. Results: Coats disease is a sporadic, usually unilateral condition typically occurring in young males. When untreated, this disorder can lead to total exudative retinal detachment and secondary glaucoma. Conclusions: Anti-VEGF agents are currently a treatment option in combination with ablative therapy of telangiectatic vessels. Anti-VEGF agents appear particularly useful for patients with extensive areas of exudative retinal detachment, and are an effective treatment option for total retinal detachment. Coats disease is a sporadic, usually unilateral, condition typically occurring in young males. When untreated, this disorder can lead to total exudative retinal detachment and secondary glaucoma. Occasionally enucleation is necessary. The purpose of our critical reappraisal of pathophysiology in Coats disease is not to provide readers with guidelines, protocols, and recommendations but sharpening the focus to the gray zones and troubles in management of these young patients in the era of anti-vascular endothelial growth factor drugs.