Clinical Characteristics of Eales Disease and the Efficacy of Different Interventions for Neovascular Complications

Abstract

Supplemental Digital Content is Available in the Text.Controversies about characteristics of Eales disease and the efficacy of different therapies have lasted for decades. Here, all available studies were analyzed and clarified the epidemiology, etiology, symptoms, clinical manifestations, and complications of Eales disease. In addition, we also made a comprehensive summary of the current treatments for neovascular complications.

A Multidisciplinary Approach to the Management of Eales Disease: A Case Report and Review of the Literature

“…The difference between the Eales disease group and the control groups was statistically significant ( p = 0.001), indicating an association between M. Tuberculosis and Eales disease [ 5 ]. A recent meta-analysis that included forty-seven studies involving 3557 patients reported that approximately 83% of the patients exhibited a positive Mantoux reaction; the tuberculosis genome was detected in 31% of patients with Eales disease using a polymerase chain reaction [ 7 ].…”

Correspondence

“…I read with interest the meta-analysis by Dr. Zhao and colleagues, 1 titled “Clinical characteristics of Eales disease and the efficacy of different interventions for neovascular complications,” published in the October issue of the journal RETINA, intended to provide a reference for the clinical diagnosis and treatment to the practicing ophthalmologists. The following methodologic issues and conclusions from pooled data warrant further discussion:The authors intended to explore the relationship between TB and Eales, but did not detail on this aspect.…”

“…2,3 We need clarity on this aspect.An oft-repeated statement that photocoagulation was directed at the areas of capillary nonperfusion OR retinal neovascularization requires clarification. 1 No recent study on Eales disease has prescribed photocoagulation exclusively for capillary dropouts without new vessels. Because Eales disease is per se an ischemic retinal vasculitis, some extent of peripheral capillary nonperfusion is nearly universal.…”

“…5 Another potentially misleading conclusion was about the use of anti-VEGF injections in cases with vitreous hemorrhage (VH): the pooled data revealed a high visual improvement rate (82%), and anatomic improvement (clearing of VH and neovascular regression) in 72% of cases. 1 These figures make anti-VEGF injections comparable to vitrectomy, where single intervention success was <90%. 1 There are few comparative studies of Eales disease with sufficient sample size to make such a conclusion.…”

“…1 These figures make anti-VEGF injections comparable to vitrectomy, where single intervention success was <90%. 1 There are few comparative studies of Eales disease with sufficient sample size to make such a conclusion. The authors' conclusions are heavily based on a single trial where the diagnosis of Eales was based solely on “ classical retinal fundoscopic findings” (NB: Eales disease is a diagnosis of exclusion) and “laboratory evidence of Eales disease” (no further details available).…”