To evaluate the role of intravitreal Triamcinolone (TA) with or without trans-scleral drainage in management of Coats disease.


Retrospective, interventional case series.


Fifteen consecutive cases with Coats disease were managed with 4mg/0.1ml intravitreal Triamcinolone injection on presentation and were followed for a minimum of one year duration. Additional management strategies including drainage of subretinal fluid through an inferior sclerotomy, p eripheral laser ablation and/or cryotherapy, cataract extraction, and vitrectomy were performed. Improvement of visual acuity could be achieved compared to preoperative vision in all cases in this series even when 40% needed cataract extraction with intra ocular lens implantation. One patient needed anti glaucoma treatment to control raised intraocular pressure in this series.


Triamcinolone with transscleral drainage has a role in improving the rate of absorption of subretinal fluid and macular exudates in advanced Coats disease. Major complication of 4mg/0.1ml intravitreal triamcinolone is cataract in 40 % of cases in children.

Take home message:

Transscleral drainage in Coats disease is the way to go in advanced exudative retinal detachment rather than PPV.

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Ihab Saad Othman