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BOOK TITLE: Retina: Medical and Surgical Management
This chapter basically focuses on the coats’ disease. Coats’ disease was first described by a Scottish ophthalmologist George Coats in 1908. it is an idiopathic disorder characterized by aneurysmal and telangiectatic retinal vessels with intraretinal and subretinal exudation and fluid. Exudative retinal detachment is a common feature present in this disease. Coats’ disease is a part of a spectrum of related genetic disorders known as “retinal hypovasculopathies” which consists of Norrie disease, familial exudative vitreoretinopathy (FEVR), fascioscapulohumeral muscular dystrophy (FSHD), and the osteoporosis pseudoglioma syndrome. Usual ophthalmoscopic evaluation is enough for the diagnosis of Coats’ retinopathy, but other disorders need to be ruled out, especially retinoblastoma. Observation and regular follow-up is advised in patients with mild, nonvision threatening disease (stage 1) in which the patient has no symptoms and in those who have end-stage disease with retinal detachment in which visual prognosis is nil. Laser photocoagulation to areas of telangiectasia and CNP should be considered if progressive exudation is documented. Direct laser of leaking vessels can be done under fluorescein guidance.