[Therapy of retinal detachment in Coats' disease]

Coats disease, an idiopathic condition of unknown etiology, includes teleangiectatic and aneurysmatic retinal vessels in association with massive subretinal exudation. Progression to retinal detachment caused by prolonged subretinal exudation means a poor prognosis. Retinal detachment surgery had always been controversial. Twelve patients (aged 7 to 48 years) with retinal detachment and Coats' disease were treated by various operations (cryotherapy, 4X; episcleral buckle, 2X; vitrectomy and gastamponade, 3X; vitrectomy and silicone-oiltamponade, 2X). One case (cryotherapy and cerclage) failed and went on to retinal detachment. In the other 11 cases the retinal was reattached successfully. However, peripheral, small areas remained detached, caused by persistent deposits of subretinal exudation. This means that the underlying Coats' disease is still active and must be treated by laser coagulation. It must also be monitored carefully, to keep an eye on the preretinal vitreous activities leading to detachment.