Eales disease

Eales disease

• An idiopathic obliterative vasculopathy. 

• The classic triad of Eales disease

– retinal phlebitis ( viens)
– peripheral retinal nonperfusion 
– vitreous hemorrhage, typically in young adults.

• Most commonly in India and the Middle East.

• Commonly dults 20 -40 years old.

• Higher incidence in men, but women also affected 

• Closely related to TB.

• Symptoms of Eales disease

– Dropped vision 
– Cobwebs or floaters.

• Signs for Eales disease

– Retinal phlebitis ( veins)

– vascular sheathing 

– NFL hemorrhages and hard exudates.

– bilateral disease but asymmetrical 

– No cells in the vitreous but hemorrhage can be seen.

– Cystoid macular edema may be present.

– Ischemia of temporal periphery with microaneurysms, venous shunting, venous beading, hard exudates, and cotton wool spots. 

– NVD and NVE in up to 80% of patients.

– NVG may also occur.

• Eales disease is a diagnosis of exclusion investigations done to rule out causes of vasculitis.

• FFA helpful shows active vasculitis, areas of ischemia and NV

• OCT may reveal CME and/or ERM

• Patients should be monitored for NV, VH and NVG 

• ERM usually after PRP but may occur without . 

• DIFFERENTIAL DIAGNOSIS of Eales disease

– Sickle cell disease.
– Diabetes mellitus.
– Branch retinal vein or artery occlusion.
– Retinal embolization.
– Retinopathy of prematurity.
– Familial exudative vitreoretinopathy.
– Hyperviscosity syndromes (leukemia). 
– Ocular ischemic syndrome.

Eales disease power point presentations :

Eales Disease

Eales’ disease, first described by the British ophthalmologist Henry Eales in 1880, is characterized by three overlapping stages of venous inflammation (vasculitis), occlusion, and retinal neovascularization. Diagnosis is mostly clinical and requires exclusion of other systemic or ocular conditions that could present with similar retinal features. In recent years, immunological, molecular biological, and biochemical studies have indicated the role of human leukocyte antigen, retinal autoimmunity, Mycobacterium tuberculosisgenome, and free radical-mediated damage in the etiopathogenesis of this disease. However, its etiology appears to be multifactorial. The management depends on the stage of the disease and consists of medical treatment with oral corticosteroids in the active inflammatory stage and laser photocoagulation in the advanced retinal ischemia and neovascularization stages.

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. 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 nonresolving vitreous haemorrhage and tractional retinal detachment.•If active TB present – treat with ATT •otherwise manage the vitreous hemorrhage – Partial h’ge – postural management with propped up position Total h’ge – Pars Plana Vitrectomy

Eales disease Videos:

Eales disease

Eales disease