Eales’ disease: diagnosis and management

Abstract

Eales' disease is an idiopathic inflammatory venous occlusive disease. It primarily affects young adults and is often bilateral. It is characterized by three overlapping stages of venous inflammation (vasculitis), occlusion, and retinal neovascularization. Diagnosis is mostly clinical and requires exclusion of other systemic or ocular conditions that could present with similar retinal features. Recurrent vitreous haemorrhage is the hall mark of Eales' disease. Treatment is usually corticosteroids in the inflammation stage and photocoagulation in the proliferative stage of the disease. Visual prognosis is good if treated early in the course of the disease.

Eales’ disease: a rare primary perivasculitis of retina

“…Patients usually present with symptoms of reduced visual acuity, floaters or vitreous hemorrhage in one eye, although fundoscopic changes are often seen bilaterally [1,4,5]. Eales disease is an idiopathic venous occlusive disease which is characterized by three overlapping stages of retinal phlebitis, peripheral nonperfusion and retinal neovascularization [1].…”

“…The pathophysiology and aetiology of Eales disease is still controversial and it has been recognised as a primary vasculitis of unknown aetiology [1]. Demonstration of tubercle bacilli in the pathological specimens of patients with primary vasculitis by Gilbert andStock in 1935 and1937[7,8] and an increased number of cases in tuberculosis endemic areas in patients with positive Mantoux tests raised a suspicion of an association between tuberculosis and Eales disease.…”

“…Several conditions including leukaemia, sarcoidosis, tuberculosis, syphilis, toxoplasmosis, systemic lupus erythematosus, Wegener's granulomatosis, Bechet's disease and viral retinitis can mimic the vasculitic phase of the disease. Diabetic retinopathy and branch and central retinal vein occlusion are the common mimickers of the proliferative phase [1].…”

“…A full course of antituberculous treatment (ATT) of 9 months along with a short course of glucocorticoids is recommended by some investigators [9], whereas some reserve ATT for patients with acute phlebitis with massive infiltration, nodule formation and complete obliteration of venous segments [1]. Vitamin B12 and folate treatment is recommended in cases of hyper homocysteinaemia until the homocysteine level returns to normal [9].…”

“…It can occur as a primary disease or present in association with various diseases. Eales disease is a rare primary perivasculitis of the retina [1]. Here we present a case of a young female presenting with reduced visual acuity who was diagnosed with Eales disease and treated successfully.…”