Natural history and management of advanced Coats' disease

Thirteen children evaluated in the Oncology Service of Wills Eye Hospital from 1976 through 1986 were found to have advanced unilateral Coats' disease, producing a total bullous exudative retinal detachment. All 13 eyes were blind. Six children were given no treatment for their retinopathy, and four of the six eventually developed painful neovascular glaucoma, necessitating enucleation of the affected eye. The other seven children underwent intraocular infusion, drainage of subretinal fluid, and cryotherapy on one or more occasions. None of these seven eyes has developed painful neovascular glaucoma, and the affected eye remains cosmetically acceptable in all seven children.