ReviewPEARLS AND PITFALLS IN DIAGNOSIS AND MANAGEMENT OF COATS DISEASEGrosso, Andrea MD*; Pellegrini, Marco MD†; Cereda, Matteo G. MD†; Panico, Claudio MD‡; Staurenghi, Giovanni MD†; Sigler, Eric J. MD§,¶Author Information *Department of Ophthalmology, Torino Eye Hospital and Centre for Macular Research and Allied Diseases, San Mauro, Italy; †Department of Biomedical and Clinical Science “Luigi Sacco”, Eye Clinic, Sacco Hospital, University of Milan, Milan, Italy; ‡Department of Ophthalmology, Torino Eye Hospital, Torino, Italy; §Ophthalmic Consultants of Long Island, Division of Retina and Vitreous, Rockville Centre, New York; and ¶Ophthalmic Consultants of Long Island, Division of Retina and Vitreous, Lynbrook, New York. Reprint requests: Andrea Grosso, MD, Department of Ophthalmology, Torino Eye Hospital and Centre for Macular Research and Allied Diseases, San Mauro T.se 10099 Via Roma 73, Italy; e-mail: firstname.lastname@example.org None of the authors have any financial/conflicting interests to disclose. A. Grosso has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. RETINA: April 2015 - Volume 35 - Issue 4 - p 614-623 doi: 10.1097/IAE.0000000000000485 Buy Metrics AbstractIn Brief Purpose: To review current literature on Coats disease and provide a structured framework for differentiating challenging clinical features in Coats disease patients. Methods: We critically reappraise historical and current literature and present clinical methods for developing a thorough differential diagnosis and management strategy for Coats disease. Results: Coats disease is a sporadic, usually unilateral condition typically occurring in young males. When untreated, this disorder can lead to total exudative retinal detachment and secondary glaucoma. Conclusions: Anti-VEGF agents are currently a treatment option in combination with ablative therapy of telangiectatic vessels. Anti-VEGF agents appear particularly useful for patients with extensive areas of exudative retinal detachment, and are an effective treatment option for total retinal detachment. Coats disease is a sporadic, usually unilateral, condition typically occurring in young males. When untreated, this disorder can lead to total exudative retinal detachment and secondary glaucoma. Occasionally enucleation is necessary. The purpose of our critical reappraisal of pathophysiology in Coats disease is not to provide readers with guidelines, protocols, and recommendations but sharpening the focus to the gray zones and troubles in management of these young patients in the era of anti-vascular endothelial growth factor drugs. © 2015 by Ophthalmic Communications Society, Inc.