Central retinal artery occlusion as a presenting symptom in Eales’ disease: a case report

Abstract

Background Eales’ disease is an idiopathic peripheral retinal vasculopathy characterized by retinal phlebitis, ischemia, retinal neovascularization, and recurrent vitreous hemorrhages. But CRAO is an unusual presentation. Case presentation A 27-year-old healthy female nurse of Indian descent presented with sudden vision loss in her right eye upon awakening. Central retinal artery occlusion (CRAO), combined with mild central retinal vein occlusion (CRVO), was diagnosed. During the second of three consecutive sessions of hyperbaric oxygen treatments, her vision rapidly improved. One week later, she developed peripheral phlebitis in the same eye. Infectious, inflammatory, and hematologic etiologies were excluded. The systemic evaluation was normal except for a positive Mantoux tuberculin skin test. Following systemic steroidal treatment, she experienced gradual improvement of her vasculitis. Two weeks later, mild retinal phlebitis appeared in her left eye. Eales’ disease was diagnosed after the exclusion of other diseases. Conclusion This is an unusual Eales’ disease case, which presented as combined CRAO with mild CRVO. The association of CRAO and Eales’ disease is reported here for the first time, to our best knowledge.

A Review of Eales’ Disease and Mycobacterium tuberculosis

“…Eales’ Disease generally presents as inflammation and ischemia with resultant neovascularization and hemorrhage [ 7 , 8 ]. These overlapping events occur predominantly in the peripheral retinal veins, but several case reports have reported arterial as well as macular involvement [ 9 , 10 , 11 ]. The early stage of Eales’ Disease is characterized by peripheral retinal periphlebitis with associated venous dilation and perivascular exudates [ 7 , 8 ].…”