Introduction: Coats disease is a sporadic, retinal vascular abnormality, causing blindness. Several interventional methods, including laser photocoagulation, have been proposed; however, the use of intravitreal dexamethasone in refractory Coats disease is not well described.
Patient concerns: A 38-year-old man presented with a painless reduction in visual acuity in his right eye, commencing 15 days prior to initial assessment.
Diagnosis: Clinical manifestations and multimodal imaging indicated Coats disease.
Interventions: Retinal laser photocoagulation was performed in the nonperfused areas, 15 months later, the exudative retinal detachment, and macular edema remained, the patient was then treated with an intravitreal slow-release dexamethasone implant.
Outcomes: The exudative retinal detachment and macular edema had resolved, and the BCVA had also improved.
Conclusion: Dexamethasone intravitreal implantation was effective in treating refractory Coats disease.