Coats disease is an eye disease that affects adolescent males. 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 not involving the central sulcus and 2B: exudation involving the central sulcus; 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 even vitreous surgery in advanced cases of retinal detachment will not change the deterioration of vision or risk the removal of the eye. In fact, Coats’ disease occurs mostly in children, and when parents discover the symptoms in their children, the retinal detachment has already occurred due to the delayed condition, and the treatment is too late at that time, which is an important reason why traditional methods are not effective. In recent years, anti-VEGF drugs have emerged internationally to treat various retinal vascular diseases. VEGF drugs are antagonists of VEGF (vascular endothelial growth factor), which, when injected into the eye, reduce the concentration of VEGF in the eye, decrease the permeability of blood vessels, reduce abnormal vascular leakage, and absorb exudative retinal detachment. In 2011, we used vitreous cavity injection of anti-VEGF drugs as initial treatment or alone to treat children with Coats disease combined with exudative retinal detachment. Coats disease achieved excellent results, which were reported twice (2011, 2014) in Graefes Arch Clin Exp Ophthalmol. and were recognized by international colleagues, which is the first international and domestic report by a national. The method is simple, and when Coats disease is diagnosed, the disease is effectively controlled by first using anti-VEGF treatment to reduce retinal edema and subretinal fluid absorption, followed by supplemental laser or cryotherapy. 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 the atrial fluid of children with Coats disease were significantly higher than those in the control group, and the concentration of VEGF in the atrial fluid of patients with stage 3B was significantly higher than that of patients with stage 3A; the concentration of VEGF in the 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 the initial treatment or as a separate treatment. The treatment strategy of Coats disease with combined exudative retinal detachment was effective.