Vitrectomy in advanced Coats disease

Background. Coats disease is a retinal vasculopathy of unknown cause. Untre ated cases usually lead to an exudative retinal detachment and rubeosis iri dis with secondary glaucoma. Photocoagulation and/or cryotherapy are genera lly the first interventions in treating the disease. Pars plana vitrectomy may be indicated in cases of vitreous hemorrhage or retinal detachment. Methods. We performed pars plana vitrectomy in 9 eyes With Coats disease be tween 1992 and 1999. A retinal detachment was present in 3 cases, and three showed a vitreous hemorrhage. In two cases surgery was indicated because o f paramacular localization of the pathological vessels with associated exud ations. Results. The two cases with paramacular involvement showed improvement in v isual acuity of eight lines. In the remaining cases visual acuity remained within two lines compared to the initial visual acuity. All eyes except one could be saved. Conclusion. Pars plana vitrectomy is a useful option in treating advanced C oats disease, especially in cases associated with vitreous hemorrhage or re tinal traction.