Coats disease: diagnosis and treatment Review article
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Published:
Jul 22, 2026
Keywords:
Coats disease, telangiectasias, exudation, retina
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Abstract
Coats disease is a rare, non-hereditary retinopathy. It is characterised by progressive destruction of the retinal blood vessels with exudates and aneurysms usually occurring unilaterally. Despite several studies, the etiology of this disease remains unclear. Treatment varies depending on the stage of the disease. Currently, laser therapy and cryocoagulation are commonly used. The disease is progressive; therefore, early diagnosis and treatment reduce the risk of severe complications.
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1.
Wolińska N, Kaczmarek J, Papież M, Pigoński A, Papachristoforou N, Ueno A, Pyza A, Piórek J, Alsoubie I, Kozak M. Coats disease: diagnosis and treatment. Ophthatherapy [Internet]. 2026Jul.22 [cited 2026Jul.26];00:A0009. Available from: https://www.journalsmededu.pl/index.php/ophthatherapy/article/view/3200
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Conservative treatment
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References
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2. Morris B, Foot B, Mulvihill A. A population-based study of Coats disease in the United Kingdom I: epidemiology and clinical features at diagnosis. Eye (Lond). 2010; 24(12): 1797-801. https://doi.org/10.1038/eye.2010.126.
3. Adeniran JF, Duff SM, Mimouni M et al. Treatment of Coats’ disease: an analysis of pooled results. Int J Ophthalmol. 2019; 12(4): 668-74. https://doi.org/10.18240/ijo.2019.04.23.
4. Sen M, Shields CL, Honavar SG et al. Coats disease: An overview of classification, management and outcomes. Indian J Ophthalmol. 2019; 67(6): 763-71. https://doi.org/10.4103/ijo.IJO_841_19.
5. Shields JA, Shields CL, Honavar SG et al. Classification and management of Coats disease: the 2000 Proctor Lecture. Am J Ophthalmol. 2001; 131: 572-83.
6. Adam RS, Kertes PJ, Lam WC. Observations on the management of Coats’ disease: less is more. Br J Ophthalmol. 2007; 91(3): 303-6. https://doi.org/10.1136/bjo.2006.103382.
7. Haik BG. Advanced Coats’ disease. Trans Am Ophthalmol Soc. 1991; 89: 371-476.
8. Glaser BM, Vidaurri-Leal J, Michels RG et al. Cryotherapy during surgery for giant retinal tears and intravitreal dispersion of viable retinal pigment epithelial cells. Ophthalmology. 1993; 100(4): 466-70. https://doi.org/10.1016/s0161-6420(93)31620-9.
9. Spitznas M, Joussen F, Wessing A. Treatment of Coats’ disease with photocoagulation. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1976; 199(1): 31-7. https://doi.org/10.1007/BF00660813.
10. Ridley ME, Shields JA, Brown GC et al. Coats’ disease. Evaluation of management. Ophthalmology. 1982; 89(12): 1381-7. https://doi.org/10.1016/s0161-6420(82)34634-5.
11. McGrand JC. Photocoagulation in Coats’ disease. Trans Ophthalmol Soc UK. 1970; 90: 47-56
12. Nucci P, Bandello F, Serafino M et al. Selective photocoagulation in coats’ disease: ten-year follow-up. Eur J Ophthalmol. 2002; 12: 501-5.
13. Ghorbanian S, Jaulim A, Chatziralli IP. Diagnosis and treatment of coats’ disease: a review of the literature. Ophthalmologica. 2012; 227(4): 175-82. https://doi.org/10.1159/000336906.
14. Bai J, Song Z, Li G et al. Efficacy and Safety of Anti-Vascular Endothelial Growth Factor Drugs for Coats’ Disease Treatment: A Systematic Review. J Ocul Pharmacol Ther. 2023; 39(7): 418-29. https://doi.org/10.1089/jop.2023.0028.
15. Yang X, Wang C, Su G. Recent advances in the diagnosis and treatment of Coats’ disease. Int Ophthalmol. 2019; 39(4): 957-70. https://doi.org/10.1007/s10792-019-01095-8.
16. Oli A, Balakrishnan D, Jalali S. Coats’ disease: trends and long-term treatment outcomes in a tertiary referral centre. Ther Adv Ophthalmol. 2021; 13: 25158414211055957. https://doi.org/10.1177/25158414211055957.
17. Kodama A, Sugioka K, Kusaka S et al. Combined treatment for Coats’ disease: retinal laser photocoagulation combined with intravitreal bevacizumab injection was effective in two cases. BMC Ophthalmol. 2014; 14: 36. https://doi.org/10.1186/1471-2415-14-36.
18. Berco E, Elsliger S, Weinberg T et al. Triple Trouble with Triple Solutions: A Unique Case Report of a Severe Exudative Retinal Detachment Accompanied by Retinal Traction and Two Retinal Holes in Coats Disease. Case Rep Ophthalmol. 2024; 15(1): 84091. https://doi.org/10.1159/000535821.
19. Sigler EJ, Randolph JC, Calzada JI et al. Current management of Coats disease. Surv Ophthalmol. 2014; 59(1): 30-46. https://doi.org/10.1016/j.survophthal.2013.03.007.
20. Judisch GF, Apple DJ. Orbital cellulitis in an infant secondary to Coats’ disease. Arch Ophthalmol. 1980; 98(11): 2004-6. https://doi.org/10.1001/archopht.1980.01020040856014.
2. Morris B, Foot B, Mulvihill A. A population-based study of Coats disease in the United Kingdom I: epidemiology and clinical features at diagnosis. Eye (Lond). 2010; 24(12): 1797-801. https://doi.org/10.1038/eye.2010.126.
3. Adeniran JF, Duff SM, Mimouni M et al. Treatment of Coats’ disease: an analysis of pooled results. Int J Ophthalmol. 2019; 12(4): 668-74. https://doi.org/10.18240/ijo.2019.04.23.
4. Sen M, Shields CL, Honavar SG et al. Coats disease: An overview of classification, management and outcomes. Indian J Ophthalmol. 2019; 67(6): 763-71. https://doi.org/10.4103/ijo.IJO_841_19.
5. Shields JA, Shields CL, Honavar SG et al. Classification and management of Coats disease: the 2000 Proctor Lecture. Am J Ophthalmol. 2001; 131: 572-83.
6. Adam RS, Kertes PJ, Lam WC. Observations on the management of Coats’ disease: less is more. Br J Ophthalmol. 2007; 91(3): 303-6. https://doi.org/10.1136/bjo.2006.103382.
7. Haik BG. Advanced Coats’ disease. Trans Am Ophthalmol Soc. 1991; 89: 371-476.
8. Glaser BM, Vidaurri-Leal J, Michels RG et al. Cryotherapy during surgery for giant retinal tears and intravitreal dispersion of viable retinal pigment epithelial cells. Ophthalmology. 1993; 100(4): 466-70. https://doi.org/10.1016/s0161-6420(93)31620-9.
9. Spitznas M, Joussen F, Wessing A. Treatment of Coats’ disease with photocoagulation. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1976; 199(1): 31-7. https://doi.org/10.1007/BF00660813.
10. Ridley ME, Shields JA, Brown GC et al. Coats’ disease. Evaluation of management. Ophthalmology. 1982; 89(12): 1381-7. https://doi.org/10.1016/s0161-6420(82)34634-5.
11. McGrand JC. Photocoagulation in Coats’ disease. Trans Ophthalmol Soc UK. 1970; 90: 47-56
12. Nucci P, Bandello F, Serafino M et al. Selective photocoagulation in coats’ disease: ten-year follow-up. Eur J Ophthalmol. 2002; 12: 501-5.
13. Ghorbanian S, Jaulim A, Chatziralli IP. Diagnosis and treatment of coats’ disease: a review of the literature. Ophthalmologica. 2012; 227(4): 175-82. https://doi.org/10.1159/000336906.
14. Bai J, Song Z, Li G et al. Efficacy and Safety of Anti-Vascular Endothelial Growth Factor Drugs for Coats’ Disease Treatment: A Systematic Review. J Ocul Pharmacol Ther. 2023; 39(7): 418-29. https://doi.org/10.1089/jop.2023.0028.
15. Yang X, Wang C, Su G. Recent advances in the diagnosis and treatment of Coats’ disease. Int Ophthalmol. 2019; 39(4): 957-70. https://doi.org/10.1007/s10792-019-01095-8.
16. Oli A, Balakrishnan D, Jalali S. Coats’ disease: trends and long-term treatment outcomes in a tertiary referral centre. Ther Adv Ophthalmol. 2021; 13: 25158414211055957. https://doi.org/10.1177/25158414211055957.
17. Kodama A, Sugioka K, Kusaka S et al. Combined treatment for Coats’ disease: retinal laser photocoagulation combined with intravitreal bevacizumab injection was effective in two cases. BMC Ophthalmol. 2014; 14: 36. https://doi.org/10.1186/1471-2415-14-36.
18. Berco E, Elsliger S, Weinberg T et al. Triple Trouble with Triple Solutions: A Unique Case Report of a Severe Exudative Retinal Detachment Accompanied by Retinal Traction and Two Retinal Holes in Coats Disease. Case Rep Ophthalmol. 2024; 15(1): 84091. https://doi.org/10.1159/000535821.
19. Sigler EJ, Randolph JC, Calzada JI et al. Current management of Coats disease. Surv Ophthalmol. 2014; 59(1): 30-46. https://doi.org/10.1016/j.survophthal.2013.03.007.
20. Judisch GF, Apple DJ. Orbital cellulitis in an infant secondary to Coats’ disease. Arch Ophthalmol. 1980; 98(11): 2004-6. https://doi.org/10.1001/archopht.1980.01020040856014.