Several complications of Coats disease, such as exudative retinal detachment, macular edema, and neovascular glaucoma, have been reported.[2] Previously described treatments, include retinal laser photocoagulation, intravitreal injection of triamcinolone acetonide or anti-vascular endothelial growth factor (VEGF); however, several consequences of these modalities have also been reported.[3, 4, 5] Here we reported a refractory case of adult-onset Coats disease, treated with an intravitreal implant, releasing dexamethasone, following ineffective laser photocoagulation therapy. Here, VEGFA is linked to macular retinal edema.