High-density vitreous substitute in the management of advanced Coats' disease.

Advanced Coats' disease is a threat to vision. Management of advanced Coats' disease has long been a challenge to ophthalmologists. Some people have attempted to use pars plana vitrectomy and intraocular diathermy on diseased vessels followed by intraocular gas or silicone oil injection. However, internal drainage is technically difficult. We present a case of advanced Coats' disease for which, after an encircling buckle and pars plana vitrectomy, intravitreal injection of perfluorodecaline was used to displace the subretinal fluid to the peripheral subretinal space, and transscleral external drainage was achieved. Finally panretinal laser photocoagulation, cryotherapy and endodiathermy were performed on diseased vessels. Visual improvement and reattachment of the posterior pole were achieved. So we think a high-density vitreous substitute can be a useful adjunct in the management of advanced Coats' disease. It minimizes the disadvantages of the internal or external approaches, while maintaining most of the advantages of both.