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Light and electron-microscopic analysis of the enucleated eye of a 55-year-old man confirmed the diagnosis of Coats' syndrome. The histopathologic findings in this adult patient are identical to those seen in typical cases of Coats' syndrome of childhood. The characteristic thickening of vessel walls and the apparent deficiency of healthy, viable retinal vascular endothelial cells support the hypothesis that the ocular changes in this syndrome are directly related to a primary retinal vascular defect leading to abnormal permeability.
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