Coats disease presenting with vitreous hemorrhage and neovascular glaucoma

To describe a patient with Coats disease with an atypical presentation of neovascular glaucoma and vitreous hemorrhage.

A 15-year-old male presented with five days of pain, redness, and swelling and was found to have neovascular glaucoma in his right eye. Further evaluation revealed Coats disease stage 3AI with a subtotal exudative retinal detachment inferiorly, telangiectatic vessels, and vitreous hemorrhage. Intravitreal anti-vascular endothelial growth factor, laser photocoagulation, pars plana vitrectomy, and valved tube-shunt placement was performed, eventually resulting in a favorable visual outcome.

We report a patient with a unique presentation of advanced Coats disease. By highlighting the treatment approach and potential factors that led to the preservation of visual function, we hope to expand the literature on the diagnosis and management of Coats disease.