Abstract
Eales’ disease is an idiopathic occlusive inflammatory vasculopathy resulting in peripheral retinal ischemia, neovascularization, recurrent hemophthalmos, and proliferative tissue formation. It is often complicated by tractional retinal detachment, secondary glaucoma, and central retinal vein occlusion. The management of patients with Eales’ disease includes mainly glucocorticosteroid therapy, the use of angiogenesis inhibitors, vitreoretinal surgery and laser photocoagulation. The clinical case reported demonstrates the potential of retinal laser photocoagulation for treatment of the Eales’ disease in the ischemic and proliferative stages. The results of retinal laser photocoagulation used as monotherapy demonstrate the clinical and functional indices improvement: enhanced visual acuity, stabilized central retinal sensitivity value, restored clarity to the ocular media, regression of neovascularization and macular edema in the patient’s eye being in the proliferative (3b) stage, and the process stabilization in the eye being in the ischemic (2a) stage of the disease.
Highlights
Eales’ disease is an idiopathic occlusive inflammatory vasculopathy, which results in peripheral retinal ischemia, neovascularization, recurrent hemophthalmos and proliferative tissue formation [1, 2]
The listed above manifestations often result in the following complications: recurrent retinal and vitreous hemorrhages, traction/rhegmatogenous retinal detachment, rubeosis iridis and secondary glaucoma [8]
The use of “rigid” retinal laser photocoagulation may result in complications, such as exudative retinal detachment, iatrogenic choroidal neovascularization, cystoid macular edema, epiretinal fibrosis, visual field deficits, deterioration in color vision and decline in contrast sensitivity [30,31,32]
Summary
Eales’ disease is an idiopathic occlusive inflammatory vasculopathy, which results in peripheral retinal ischemia, neovascularization, recurrent hemophthalmos and proliferative tissue formation [1, 2]. Etiopathogenesis of the Eales’ disease is not completely understood. According to the literary sources, the disorder usually presents with involvement of peripheral retina and is characterized by a number of manifestations of varying intensity: inflamed veins, ischemia and retinal neovascularization. The listed above manifestations often result in the following complications: recurrent retinal and vitreous hemorrhages, traction/rhegmatogenous retinal detachment, rubeosis iridis and secondary glaucoma [8]. The “gold standard” in the Eales’ disease detection is fluorescein angiography (FA) allowing one to assess blood flow and damage to retinal blood vessels: dye transudation, retinal vascular tortuosity and telangiectasia, vascular shunt, venous stasis, ischemia, retinal neovascularization [10,11,12]. Stage 1 (1a) Periphlebitis of small caliber vessels (1b) Periphlebitis of large caliber vessels with superficial retinal hemorrhages
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