Purpose: To report on surgical outcomes of removing subfoveal nodules and to evaluate the histopathological findings of subfoveal nodules in pediatric patients with coats’ disease. Methods: This was a retrospective, interventional case series in which 6 pediatric patients had large (>1 disk diameter) subfoveal nodules. Vitrectomy and excision of subfoveal nodules with silicon oil tamponade were performed. Silicon oil was removed 3 months later. Results: This study was carried out in 6 patients with a mean follow-up of 9.2±1.5 months (range: 7-11 months), and the mean age was 5.2±2.4 years (range: 2-8 years). Preoperative visual acuity ranged from light perception (LP) to 20/250, and postoperative visual acuity ranged from LP to 20/200. Histopathology revealed nodules composed of proliferating fibrous tissue, hyaline degeneration with foamy histiocytes, focal myofibroblast hyperplasia, ossified tissue, and cholesterol fissures, with chronic cellular infiltration. No nodules regressed during the follow-up period. Conclusion: Certain eyes of pediatric patients with coats’ disease who underwent subfoveal nodule removal and no evidence of nodule regression may benefit from submacular surgery. Histopathological findings revealed that anti-proliferative and anti-fibrotic agents could be targets for treating coats disease.
