Eales disease

Eales disease
Specialty Ophthalmology Edit this on Wikidata

Eales disease is a type of obliterative vasculopathy, also known as angiopathia retinae juvenilis, periphlebitis retinae, primary perivasculitis of the retina, is an ocular disease characterized by inflammation and possible blockage of retinal blood vessels, abnormal growth of new blood vessels (neovascularization), and recurrent retinal and vitreal hemorrhages.[1] Eales' disease with a characteristic clinical picture, fluorescein angiographic finding, and natural course is considered a specific disease entity.

Presentation

Patients are often asymptomatic in the initial stages of retinal perivasculitis. Some patients may develop symptoms such as floaters, blurring vision, or even gross diminution of vision due to massive vitreous hemorrhage. Vision in these patients can be normal to hand movements or light perception only. Bilaterality is quite common (50–90%) patients.

Aetiology

The cause of this condition is not known. However, in a significant number of patients, DNA of the bacterium Mycobacterium tuberculosis was detected by PCR.[2]

Pathology

It is characterized by three overlapping stages of venous inflammation (vasculitis), occlusion, and retinal neovascularization.

Diagnosis

Diagnosis of eales disease is mainly clinical with exclusion .

Treatment

Treatment of Eales’ disease comprises: 1. Medical treatment: A course of oral corticosteroids for extended periods is the main stay of treatment during active inflammation. A course of antitubercular therapy has also been recommended in selective cases.

2. Laser photocoagulation of the retina is indicated in stage of neovascularizion.

3. Vitreoretinal surgery is required for nonresolving vitreous haemorrhage and tractional retinal detachment.[3] •If active TB present - treat with ATT •otherwise manage the vitreous hemorrhage - Partial h’ge - postural management with propped up position Total h’ge - Pars Plana Vitrectomy

Epidemiology

Eales disease most commonly affects healthy young adults. Male predominance (up to 97.6%) has been reported in a majority of the series. The predominant age of onset of symptoms is between 20 and 30 years. The disease is now seen more commonly in the Indian subcontinent.

History

The condition was first described in young adult men by Henry Eales (1852–1913), an English Ophthalmologist in 1880.[4] Although men have been reported to have an increased prevalence of Eales disease, one study reported that men and women are affected equally.[5]

See also

References

  1. ↑ Cassin, B.; Solomon, S. (1990). Dictionary of Eye Terminology. Gainesville, Florida: Triad Publishing Company.
  2. ↑ Madhavan, HN; Therese, KL; Doraiswamy, K (March 2002). "Further investigations on the association of Mycobacterium tuberculosis with Eales' disease". Indian J Ophthalmol. 50 (1): 35–9. PMID 12090085.
  3. ↑ Comprehensive Ophthalmology, (4th Ed) 2007 by A K Khurana, Professor, Regional Institute of Ophthalmology, Postgraduate Institute of Medical Sciences, Rohtak- 124001, India
  4. ↑ Elliot, AJ (1954). "Recurrent intraocular hemorrhage in young adults (Eales's Disease): A report of thirty-one cases". Transactions of the American Ophthalmological Society. 52: 811–75. PMC 1312611. PMID 13274441.
  5. ↑ Eales disease at eMedicine
Classification
External resources
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