Eales’ disease: epidemiology, diagnostic and therapeutic concepts

Abstract

Background To describe the epidemiological traits, clinical characteristics, diagnostic procedures, therapeutic interventions and evolution in a large series of patients with diagnosis of Eales’ disease. Methods A clinical retrospective review of patients with Eales’ disease, evaluated and treated between April 2009 and April 2018, with a 1-year minimum follow-up. Thirty patients (59 eyes), were included. Age, sex, laboratory results (CBC, glycemia, protein electrophoresis, ACE levels) immunological profile and a Quantiferon-TB Gold Plus test were recorded. The patients were divided into groups according to their evolution, medical or surgical treatment, and visual outcomes. Results Seventeen male patients and 13 female patients were included, and their ages ranged from 14 to 35 years. The Quantiferon-TB Gold Plus test was positive in 25 patients. Twenty-eight patients had unilateral vitreous hemorrhage, 10 of whom presented with vasculitis and non-perfusion areas in the contralateral eye, 9 presented contralateral peripheral neovascularization and 9 had contralateral fibrovascular proliferation. The remaining 2 patients presented with a rhegmatogenous retinal detachment. In 6 patients, conservative treatment with intravitreal anti-VEGF injections and photocoagulation was performed after the hemorrhage cleared. Twenty-two patients, required vitrectomy, with good visual outcomes. Macular edema was found in 16 eyes, which responded to periocular and/or systemic corticosteroid therapy, except for 9 eyes that required intravitreal bevacizumab, with complete resolution in 7 eyes and partial resolution in 2 eyes. Conclusions Eales’ disease is a pathology of significant prevalence in our country. The distribution according to sex, tends to be equivalent. The etiology, even when it is not specifically determined, according to laboratory tests, confirms the probable immunologic response in the presence of Mycobacterium tuberculosis antigens. This is still a diagnosis of exclusion, and therefore, it is advisable to perform a complete laboratory work-up in each case. Timely application of laser and other medical treatments, help to avoid progression to more advanced stages and their complications. The surgical treatment of vitrectomy for vitreous hemorrhage, and/or tractional vitreous detachment yields good primary anatomical and functional outcomes. Secondary macular edema responds to periocular and intravitreal corticosteroids, and in refractory cases, the use of anti-VEGF therapy leads to an effective resolution.

Eales Disease

“…Başvuru anındaki görme keskinliği el hareketleri ile 0,5 arasında değişebilir. [20] Ön üveit çok nadir olmakla birlikte şiddetli aktif perivaskulitlerde "spillover ön üveit" görülebilir. Bu ön üveit her zaman nongranülomatözdür.…”

Seltene vaskuläre Erkrankungen der Netzhaut – Teil 1

“…Epidemiologie, Pathophysiologie und Klinik Beim Morbus Eales handelt es sich um eine retinale Gefäßerkrankung mit peripheren nicht perfundierten Netzhautarealen und rezidivierenden Glaskörperblutungen aufgrund von Neovaskularisationen hauptsächlich bei jungen Männern [21]. Erstmals 1880 durch H. Eales beschrieben wird die ätiologisch ungeklärte Erkrankung als klinisches Syndrom mit spezifischen Befunden und einem typischen Verlauf aufgefasst.…”

A Comprehensive Update on Retinal Vasculitis: Etiologies, Manifestations and Treatments

“…The venous vessels are predominantly affected. Vascular nonperfusion and secondary neovascularization are typical clinical changes [135][136][137]. In accordance with the assumed autoimmunological genesis of the disease, basic therapeutic agents are applied as cDMARDs and increasingly as bDMARDs.…”

“…The venous vessels are predominantly affected. Vascular nonperfusion and secondary neovascularization are typical clinical changes [135][136][137].…”