The authors describe a 34-month-old boy who presented with a bilateral and asymmetric exudative retinopathy with similarities to Coats' disease. The patient's medical history was remarkable for hypotonia, developmental delay, seizures, and intracranial calcifications. Genetic testing revealed a diagnosis of Coats' plus. This rare genetic disease should be in the differential diagnosis in patients who present with a bilateral and asymmetric Coats'-like retinopathy in the presence of other systemic abnormalities.
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