Integrating scleral buckling, transscleral drainage of subretinal fluid, intravitreal anti-vascular endothelial growth factor, and laser photocoagulation in stage 3B Coats' total retinal detachment

The integration of quadruple therapy in a 13-year-old boy with stage 3B Coats' disease achieved retinal reattachment and visual improvement. Scleral buckling might play a role in retinal detachment in Coats' disease, although it has previously been considered insignificant. Instead of performing vitrectomy and internal drainage with a drainage hole in the retina, less-invasive procedures that do not require retinotomy appear to be beneficial in cases of advanced Coats' disease.