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Eales disease of eye
It is inflammation of the peripheral retinal veins. It is characterised by recurrent vitreous haemorrhage so also referred to as primary vitreous haemorrhage.
Etiology of Eales disease.
It is not known exactly. Many workers
consider it to be a hypersensitivity reaction to tubercular proteins.
Clinical features of Eales disease.
It is a bilateral disease, typically affecting young adult males.
The common presenting symptoms are sudden appearance of floaters (black spots) in front of the eye or painless loss of vision due to vitreous haemorrhage.
The haemorrhage clears up but recurrences are very common.
Clinical stages of Eales Disease
Clinical course of the Eales’ disease can be described in four stages:
1. Stage of inflammation.
The affected peripheral veins are congested and perivascular exudates and sheathing are seen along their surface.
Superficial haemorrhages ranging from flame-shaped to sheets of haemorrhages may be present near the affected veins.
2. Stage of ischaemia
It is characterized by obliteration of the involved vessels and development of avascular areas in the periphery as evidenced on fundus fluorescein angiography.
3. Stage of retina neovascularization
It is marked by development of abnormal fragile vessels at the junction of perfused and non-perfused retina.
Bleeding from these vessels leads to recurrent vitreous haemorrhage.
4. Stage of sequelae
It is characterized by development of complications such as proliferative vitreoretinopathy, tractional retinal detachment, rubeosis iridis and neovascular glaucoma.
Treatment of Eales’ disease comprises:
1. Medical treatment.
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 non resolving vitreous haemorrhage and tractional retinal detachment.