Triple intravitreal bevacizumab, sub-Tenon′s triamcinolone, and panretinal photocoagulation in Eales′ disease

Abstract

Introduction Eales' disease (ED) is an idiopathic inflammatory vasoproliferative retinal disease primarily affecting the peripheral retina of young and apparently healthy adult men, mostly from the Indian subcontinent. It is characterized by peripheral retinal inflammation, retinal neovascularization, and recurrent vitreous hemorrhage, with or without retinal detachment. Objective This study was carried out to evaluate triple therapy, with intravitreal bevacizumab (IVB), posterior sub-Tenon's (SBT) triamcinolone, and panretinal photocoagulation (PRP), in ED patients with vitreous hemorrhage and its associated vasculitis, neovascularization, and macular edema. Design This was a prospective, interventional case series. Patients and methods This study included 20 eyes of 20 patients with vitreous hemorrhage because of ED. Preoperative evaluation included patient age, sex, race, medical history, medications, complete ophthalmological examination, and diagnostic laboratory evaluation. All eyes were treated with IVB, posterior SBT triamcinolone, and PRP. The follow-up period was up to 6 months. The main outcome measures were visual acuity, intraocular pressure changes, and recurrence of vitreous hemorrhage. Results A statistically significant improvement in visual acuity was observed at 1 week and 1, 3, and 6 months postoperatively. There was no statistically significant change in intraocular pressure at any of the postoperative follow-up intervals. There was no intraoperative or postoperative complication. None of the patients included had any recurrence during the follow-up. Conclusion The triple therapy with IVB, posterior SBT triamcinolone, and PRP seems to be effective in the treatment of ED patients with dense vitreous hemorrhage and its associated vasculitis, neovascularization, and macular edema.