Coats disease is an eye disease that affects adolescent males, and although the incidence of this disease is low, the traditional treatment results in “nine out of ten” blindness. So why? The main fundus changes in Coats disease are: abnormal retinal vasodilatation, especially behind the second branch of capillaries and abnormal vascularity causing exudation and exudative retinal detachment. The disease is divided into 5 stages (Shield stage): Stage 1: tortuous dilatation of vessels only; Stage 2: tortuous dilatation of vessels with exudation, of which 2A: exudation without involvement of the central recess and 2B: exudation with involvement of the central recess; Stage 3: exudative retinal detachment, of which 3A: incomplete retinal detachment and 3B: total retinal detachment; Stage 4: total retinal detachment with glaucoma; Stage 5: lesions progresses to the end stage. The traditional treatment is laser treatment for abnormal retinal vessels, but once the abnormal vessels leak and form an exudative retinal detachment, laser cannot be completed, and freezing is not effective when there is too much subretinal fluid, and in advanced cases of retinal detachment, even vitreous surgery will not change the deterioration of vision or the risk of eye removal. In fact, Coats’ disease occurs mostly in children, and when parents notice the symptoms in their children, the retinal detachment has already occurred due to the delay of the disease, and the treatment is too late at that time, which is an important reason why the traditional method is not effective. When Coats disease is diagnosed, it is treated with anti-VEGF therapy to reduce retinal edema and subretinal fluid absorption, followed by laser or cryotherapy to effectively control the disease. The best corrected visual acuity of children 6 months after treatment was significantly improved compared to the pre-treatment period. It was demonstrated that the levels of IL-6 and VEGF in atrial fluid were significantly higher in children with Coats’ disease compared with the control group, and the VEGF concentration in atrial fluid was significantly higher in patients with stage 3B than in patients with stage 3A; the VEGF concentration in atrial fluid was significantly lower after anti-VEGF treatment, which demonstrated the rationality of anti-VEGF treatment and confirmed the use of vitreous cavity injection of anti-VEGF drugs as initial treatment or as treatment alone. The treatment strategy of Coats disease with combined exudative retinal detachment was effective.