Coats’ disease is a rare ocular condition characterised by an abnormality in the blood vessels of the retina, which become dilated and fragile. This abnormality leads to leakage of fluids and lipids, which accumulate in the retinal tissue, potentially causing inflammation and progressive vision loss. Also known as exudative retinitis, this disease most often occurs unilaterally in children and adolescents, particularly males.
The exact cause of Coats’ disease is not yet fully understood, but it is believed to be associated with certain genetic syndromes. Despite being rare, early recognition is important, as its development can be silent and easily confused with other more serious conditions, such as retinoblastoma.
Early signs of the disease may include reduced visual acuity, strabismus, or leukocoria — a whitish reflex in the pupil, often described as a “cat’s eye.” As it progresses, the condition can lead to complications such as retinal detachment, cataract, glaucoma, and, in extreme cases, complete vision loss.
Diagnosis is based on specific ophthalmological examinations, such as direct ophthalmoscopy and fluorescein angiography, which allow evaluation of the retinal vascular network and identification of the typical changes of the disease. Additional tests, such as ocular ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI), may be used to exclude other conditions with a similar presentation.
Treatment for Coats’ disease depends on the stage at which it is diagnosed. In the early stages, laser photocoagulation and cryotherapy are the most commonly used options. In more advanced stages, when complications are already present, surgery may be required, particularly in cases of retinal detachment or glaucoma.
Although rare, Coats’ disease warrants attention due to the potential impact on vision, especially in school-aged children. Early diagnosis and timely treatment are crucial to preserve visual function and prevent complications. Therefore, if signs such as sudden vision loss, strabismus, or a whitish reflex in the pupil are observed, it is essential to seek specialised medical evaluation.
24, October 2025
