Management Of Eales’ Disease Grade III B: A Rare Case
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Abstract
Introduction: Eales' disease is an idiopathic, bilateral, occlusive retinal vasculopathy that primarily affects young, predominately male patients. It seems to have multiple causes and is probably immunologic in nature. Recurrent vitreous hemorrhages, macular degeneration, and tractional or mixed retinal detachments involving the macula can all cause some patients to experience severe vision loss.
Case Report: A 39-year-old male with vitreous hemorrhage caused by Eales Disease grade III B
with an initial visual acuity 1/300 came to our department. Ultrasound imaging showed the
membrane like lesion with 1/2 retinal reflectivity, after moderate movement and vitreous
hemorrhage on both eyes. The photo-fundus showed there is decreased fovea reflex and
perimacular exudate with visible contours of sclerotic blood vessels, visible cotton wall spot, and
macroaneurysm. There is also haze grade 3 on media, visible folds in the inferior part, visible
shadows of cotton wall spots. The patient underwent pars plana vitrectomy with endolaser to
manage the disease.
Discussion: In this case, patient was diagnosed as vitreous hemorrhage caused by Eales Disease
grade III B on both eyes but it getting worse on left eye further. We chose to perform PPV with
endolaser on right eye. Based on improved visual acuity and less hemorrhage, the right eye's
outcome was favorable, while the left eye, which was not treated, had a worsening of the
situation. Only eyes with a non-resolving vitreous hemorrhage after three months should have a
vitrectomy.
Conclusion: The treatment of this patient's case produced good anatomical and functional
outcomes for the right eye, but the left eye, unfortunately, has a major issue. In order to further
confirm the results, longer follow-up is still required.
Keywords
Eales' disease, Pars plana vitrectomy, Silicone oil, Endolaser
Article Details
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