Presentation
'Eales disease' is an idiopathic bilateral occlusive periphlebitis with neovascularisation and mostly presents with vitreous hemorrhage. A 30 year old male presented with diminution of vision in left eye (6/36) for 1 month. [ncbi.nlm.nih.gov]
Entire Body System
- Recurrent Inflammation
These patients also did not have any recurrences of inflammation during the follow up period. [medresearch.in]
- Burkina Faso
Indian Journal of Ophthalmology. 2011; 59(4): 297-301 [Pubmed] 3 Maladie de Eales : à propos d’un cas au Burkina Faso J.W. Diallo, Z. Nikiema, A. Daboue, H. Tieno, N. Meda, G.R. [ijo.in]
Eyes
- Retinal Hemorrhage
Figure 1 : A) vitreous hemorrhage, retinal hemorrhage, periphlebitis and retinal periphery ischemia ; (B, C, D): shows retinal neovascularization and peripheral ischemic lesions [panafrican-med-journal.com]
hemorrhages) and 15 healthy controls. [ncbi.nlm.nih.gov]
Introduction: In 1880 and 1882, Henry Eales - “primary recurrent retinal hemorrhage”. Similar conditions of retinal and vitreous hemorrhage were described under the name of Eales’ Disease. [slideshare.net]
[…] finally, retinal or optic disk neovascularization and recurrent hemorrhages with or without retinal detachment. [neurologyindia.com]
- Retinal Lesion
[…] to stabilize the retinal lesions and maintain functional levels of vision. [ncbi.nlm.nih.gov]
Stock 18 and Gilbert 19 have shown acid fast bacilli in the peripheral retinal lesion and perivascular sheaths in eyes with primary phlebitis. [nature.com]
Other retinal lesions may be a clue to systemic associations and syndromes. [retinalphysician.com]
They concluded that periodic follow-up and early photocoagulation treatment is useful in stabilization of the retinal lesions and in maintenance of functional levels of vision in ED. [jeos.eg.net]
- Vitreous Floaters
Vitreous floaters or blurring of vision, symptoms attributable to recurrent vitreous hemorrhages. 80% between the age of 20-40 years and 95% were male (O.K Malla and co workers) 54.34% between 20-30 years and 94.73% male Rare in more developed countries [slideshare.net]
Can be unilateral or bilateral.90% bilateral (Duke Elder) 56.14% had bilateral retinal vasculitis( O.K Malla and coworkers) Slide 45: Vitreous floaters or blurring of vision, symptoms attributable to recurrent vitreous hemorrhages. 80% between the age [authorstream.com]
- Background Retinopathy
retinopathy and retinal vascular changes 2016 2017 2018 2019 Non-Billable/Non-Specific Code Code Also any associated hypertension ( I10.- ) Background retinopathy and retinal vascular changes H35.06 ICD-10-CM Diagnosis Code H35.06 Retinal vasculitis [icd10data.com]
- Painful Ophthalmoplegia
KEYWORDS: Eales disease; Tolosa–Hunt syndrome; painful ophthalmoplegia [ncbi.nlm.nih.gov]
Urogenital
- Cesarean Section
She was stable until 2011 after childbirth (cesarean section). [ncbi.nlm.nih.gov]
Neurologic
- Spastic Quadriplegia
Various neurological associations like spastic quadriplegia, internuclear ophthalmoplegia and multiple sclerosis have also been documented to be associated with Eales disease but none of the patients included in our study had such associations. [medresearch.in]
- Quadriplegia
Various neurological associations like spastic quadriplegia, internuclear ophthalmoplegia and multiple sclerosis have also been documented to be associated with Eales disease but none of the patients included in our study had such associations. [medresearch.in]
- Cerebellar Disease
Detailed neuropathologic examination was carried out on 1 case of Eales' disease with CNS involvement, in the form of retinal vasculopathy, followed first by signs of brain stem and cerebellar disease and then by a myelopathy, with death 4 years later [ncbi.nlm.nih.gov]
- Cerebellar Sign
The examination revealed bilateral retinal perivasculitis with pyramidal signs and left sided cerebellar signs. Investigations revealed an ESR of 40 mm at the end of first hour. His CT head revealed bilateral basal ganglionic infarcts. [ncbi.nlm.nih.gov]
Workup
His workup for connective tissue disorders was negative. He was put on ATT with steroids. Eales' disease is presumed allergy to tuberculoprotein. A trial of ATT with steroids has been tried with varying results. [ncbi.nlm.nih.gov]
If the patient's workup suggests an underlying systemic cause, then further examinations and laboratory tests should be performed. [symbiosisonlinepublishing.com]
A full systemic workup was performed, including CBC, hemoglobin A1C, sickle screen, PT/PTT, basic metabolic panel, RPR, FTA-Abs, ANA, ANCA, ACE, Lyme, HIV and a chest X-ray. [reviewofophthalmology.com]
In this article we review the signs, symptoms, workup and treatment options of this disease. [ecronicon.com]
Central retinal vein occlusion in a young adult should be investigated for inflammatory etiology (see diagnostic workup, below) because it represents a rare presentation of Eales. 1 Coats disease, familial exudative vitreoretinopathy (FEVR) and sickle-cell [entokey.com]
Microbiology
- Mycobacterium Fortuitum
The isolation of Mycobacterium fortuitum from the aqueous humour of a patient with classical Eales' disease, led us to hypothesize that rapid growing nontuberculous mycobacteria (RGNTM), particularly M. fortuitum and M. chelonae could be associated with [ncbi.nlm.nih.gov]
Other Pathologies
- Retinal Phlebitis
phlebitis, the onset of ischemia and retinal vessels neo area is often revealed by vitreous hemorrhage. [panafrican-med-journal.com]
Retinal phlebitis Retinal phlebitis is characterized by mid-peripheral venous dilation, perivascular exudates along the peripheral veins, and superficial retinal haemorrhages. [nature.com]
Characteristic features include inflammation of the peripheral retinal vasculature causing retinal phlebitis that can lead to retinal non-perfusion, neovascularization and recurrent vitreous hemorrhages. [symbiosisonlinepublishing.com]
HLA Type
- HLA-DR3
HLA DR3 was found in 20 patients of group-I and none in group-II. HLA types A1, B8, B5 (51) and DR 15 (2) were found in 12 out of 32 patients of eales disease and none in controls. [ncbi.nlm.nih.gov]
- HLA-DQ2
HLA DQ2 and DR52 was found in 28 cases of group-I as compared to 18 cases of group-II (p = .005). [ncbi.nlm.nih.gov]
Treatment
Forty-three eyes had undergone laser therapy; their rate of visual acuity 320/30 improved from 53% before treatment to 60% after treatment. [ncbi.nlm.nih.gov]
This article describes all these modes of treatment in a young patient suffering from Eales’ disease. [journals.viamedica.pl]
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. [en.wikipedia.org]
Prognosis
Visual prognosis is good if treated early in the course of the disease. [ncbi.nlm.nih.gov]
Visual prognosis is good if treatment begins early in the course of the disease. Source: Genetic and Rare Diseases Information Center (GARD), supported by ORDR-NCATS and NHGRI. [diseaseinfosearch.org]
Etiology
CONCLUSION: Patients with a high TST reading and ESR value and a positive PCR in vitreous samples have a high likelihood of having M. tuberculosis as an etiology. [ncbi.nlm.nih.gov]
Etiology The etiology of ED remains elusive; some studies suggest that T cell infiltration and certain peptide growth factors, such as vascular endothelial growth factor (VEGF), have a key role in the process of neovascularization. [orpha.net]
Conclusion: Patients with a high TST reading and ESR value and a positive PCR in vitreous samples have a high likelihood of having M. tuberculosis as an etiology. [ijmm.org]
Epidemiology
We present such a case with peculiar epidemiology in which the only efficient therapeutic approach in order to maintain functional vision was repeated intravitreal dexamethasone implants (Ozurdex®). [ncbi.nlm.nih.gov]
Summary Epidemiology ED is most commonly observed on the Indian subcontinent where the reported incidence is 1/200-1/250 ophthalmic patients. Males are predominantly affected. [orpha.net]
It is possible that the association of Eales disease with both ocular inflammation and sensitivity to tuberculin protein suggests that this disease may be associated with immunologic phenomena whose mechanisms remain unknown. [1] Epidemiology Frequency [emedicine.medscape.com]
Pathophysiology
The pathophysiology of Eales disease is mostly unknown. Eales disease is believed to be a primary, noninflammatory disorder of the walls of peripheral retinal vessels, namely the shunt vessels. [premilife.com]
Pathophysiology : Pathophysiology Mostly unknown primary, noninflammatory disorder of the walls of peripheral retinal vessels, namely the shunt vessels vascular occlusions, peripheral neovascularization, and vitreous hemorrhage Pathophysiology : Pathophysiology [authorstream.com]
[…] retinal vessels, namely the shunt vessels vascular occlusions, peripheral neovascularization, and vitreous hemorrhage 8 Pathophysiology The microvascular abnormalities are seen at the junction of perfused and nonperfused zones of the retina. [slideplayer.com]
Comprehensively updated to reflect everything you need to know regarding retinal diagnosis, treatment, development, structure, function, and pathophysiology, this monumental ophthalmology reference work equips you with expert answers to virtually any [books.google.com]
Pathophysiology The pathophysiology of Eales disease is mostly unknown. Eales disease is believed to be a primary, noninflammatory disorder of the walls of peripheral retinal vessels, namely the shunt vessels. [emedicine.medscape.com]
Prevention
CONCLUSION: Early vitrectomy in established cases of Eales' disease provides satisfactory results and helps in preventing complications, which are difficult to treat. [ncbi.nlm.nih.gov]