Eales disease

Eales disease is an idiopathic, inflammatory condition that primarily affects the retina of the eye. It is characterized by recurrent episodes of retinal vasculitis, peripheral retinal ischemia, and neovascularization. The disease predominantly affects young adults, particularly males, and can lead to significant visual impairment if not managed appropriately.

Etiology

The exact cause of Eales disease remains unknown. However, it is believed to be associated with an abnormal immune response. Some studies suggest a possible link to tuberculosis due to the presence of Mycobacterium tuberculosis DNA in the ocular fluids of some patients.

Pathophysiology

Eales disease progresses through three stages:

1. Inflammatory stage: Characterized by periphlebitis and retinal vasculitis.
2. Ischemic stage: Marked by retinal ischemia and capillary non-perfusion.
3. Proliferative stage: Involves neovascularization, which can lead to vitreous hemorrhage and tractional retinal detachment.

Clinical Features

Patients with Eales disease typically present with:

• Floaters
• Sudden loss of vision
• Photopsia
• Scotoma

On examination, signs may include:

• Retinal hemorrhages
• Venous sheathing
• Neovascularization
• Vitreous hemorrhage

Diagnosis

Diagnosis is primarily clinical, supported by imaging studies such as:

• Fluorescein angiography
• Optical coherence tomography
• Fundus photography

Treatment

Management of Eales disease includes:

• Corticosteroids to reduce inflammation
• Anti-tubercular therapy if associated with tuberculosis
• Laser photocoagulation to manage neovascularization
• Vitrectomy for non-resolving vitreous hemorrhage or retinal detachment

Prognosis

The prognosis of Eales disease varies. Early diagnosis and appropriate treatment can help preserve vision. However, complications such as recurrent vitreous hemorrhage and retinal detachment can lead to significant visual impairment.

Related Pages

• Retina
• Retinal vasculitis
• Neovascularization
• Vitreous hemorrhage
• Retinal detachment
• Tuberculosis