Coats' Disease

  • Medical Author:
    Frank J. Weinstock, MD, FACS

    Dr. Weinstock is a board-certified ophthalmologist. He practices general ophthalmology in Canton, Ohio, with a special interest in contact lenses. He holds faculty positions of Professor of Ophthalmology at the Northeastern Ohio Colleges of Medicine and Affiliate Clinical Professor in the Charles E. Schmidt College of Biomedical Science at Florida Atlantic University.

  • Medical Editor: Andrew A. Dahl, MD, FACS
    Andrew A. Dahl, MD, FACS

    Andrew A. Dahl, MD, FACS

    Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

How is staging of Coats' disease determined?

Carol Shields, MD, and Jerry Shields, MD, have divided Coats' disease into five stages:

Stage 1 is characterized by telangiectasia (spider veins) only.

Stage 2 demonstrates telangiectasias and exudation and is further subcategorized depending on involvement of the fovea (center of the retina, with the sharpest vision).

Stage 3 demonstrates subtotal retinal detachment, also subcategorized based on foveal involvement.

Stage 4 exhibits total retina detachment (RD) with glaucoma.

Stage 5 is end-stage disease with a blind, painless or painful eye and total RD, often with cataract and eventual phthisis bulbi (shrinkage of the eyeball after trauma or disease).

This is a progressive disease with no visual impairment in the early stages of the disease. If caught in an early stage (relatively rare since it usually isn't recognized by the child), freezing or laser treatment of the retina may be quite successful.

The disease progresses from mild blood vessel changes (treatable with the laser or by freezing) to more significant blood vessel involvement.

What is the treatment for Coats' disease?

Occasionally the disease stops on its own and may even reverse itself. Treatment is aimed at halting the blood vessel progression and is of limited value. Freezing (cryotherapy) or laser photocoagulation may be used with limited success. However, if the leaking blood vessels are clustered around the optic nerve, this treatment is not recommended as accidental damage to the nerve itself can result in worsening of vision.

Can Coats' disease be prevented?

No, Coats' disease cannot be prevented.

Risk factors have not been identified. The individual is born with this disease which develops sometime later in life.

Medically Reviewed by a Doctor on 11/19/2015

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