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Eales Disease

Idiopathic Retinal Vasculitis


Presentation

  • The presented case adds new evidence to microvasculopathy being a pathogenetic factor in Meniere's disease.[ncbi.nlm.nih.gov]
Retinal Hemorrhage
  • hemorrhages) and 15 healthy controls.[ncbi.nlm.nih.gov]
  • 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]
  • Minute retinal hemorrhages as well as minute vascular brackets or hooklets connecting two adjoining vessels. active periphlebitis with subhyaloid hemorrhage over the macula. 17.[slideshare.net]
  • Opthalmoscopic examination showed features of active retinal vasculitis in both the eyes, with multiple retinal hemorrhages and disk neovascularization [Figure 3]. Panretinal photocoagulation was done to prevent further hemorrhages.[neurologyindia.com]
Retinal Lesion
  • The retinal lesions found during the first examination included vascular sheathing, disc and/or retinal neovascularization, vitreous hemorrhage, branch retinal vein occlusion, retinitis proliferans, and retinal detachment.[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]
  • 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]
  • Other retinal lesions may be a clue to systemic associations and syndromes.[retinalphysician.com]
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]
Cesarean Section
Myelopathy
  • The first Thai case of Eales' disease with myelopathy is reported. This entity must be differentiated from other causes of myelopathy such as those due to infectious-inflammatory causes.[ncbi.nlm.nih.gov]
Neurologic Manifestation
  • We report the case of a patient with Eales disease who had internuclear ophthalmoplegia thought to be a neurologic manifestation of this disease.[ncbi.nlm.nih.gov]
Peripheral Neuropathy
  • We describe the first patient, to our knowledge, to receive a diagnosis of active tuberculosis and concurrent, severe neurological Eales disease, including peripheral neuropathy. The patient recovered completely after receiving steroid therapy.[ncbi.nlm.nih.gov]
Spastic Paraplegia
  • The first case evinced spastic paraplegia and minimal bladder dysfunction. The unusual features were that the neurologic deficit progressed over 2 years and sensations were normal. Cerebrospinal fluid (CSF) proteins were raised.[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]
  • 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]
  • 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]
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]
Retinal Phlebitis
  • EALES disease: No typical clinical presentation Cite this: The Pan African Medical Journal. 2014;17:136. doi:10.11604/pamj.2014.17.136.4019 Received: 13/02/2014 - Accepted: 17/02/2014 - Published: 26/02/2014 Key words: Eales disease, retinal phlebitis[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-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]
  • 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]

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]
Sex distribution
Age distribution

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]
  • 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]
  • […] 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]
  • 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]

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