A clinical study on eales disease.

Eales Disease can be defined as primary idiopathic perivasculitis unaccompanied by other ocular inflammatory disorders or obvious systemic disease. The most striking feature of the inflammatory disease is the occurrence of hemorrhage in the retina or in the vitreous or the recurrence of hemorrhage in the later and arising there from, the complications. The most feared are retinitis proliferance detachment of retina, complicated cataract and secondary glaucoma in the order of frequency. CONCLUSION: Eales disease with its characteristic clinical features and flourescein angiographic findings is a specific vitreoretinal disease. From this study, it is evident that the most common presentation is vitreous hemorrhage in young healthy males. It has been observed that the earlier the patient develop the disease, the more common the patient may go in for complications and visual prognosis was relatively better in patients who had a later onset of disease. If the cases are detected early and treated adequately with laser, based on the FFA as the hemorrhage resolves, and early intervention of non-resolving vitreous hemorrhage prevents visual deterioration. In this study, there was found to be no association with any systemic diseases. Eales disease has been delinked from systemic tuberculosis. Even in our study, one in 72 cases had active tuberculosis. This has statistically insignificant association. Although its aetio pathogenesis remains unclear the management options are quiet clear. Systemic steroid has been found to be beneficial in the active perivasculitis stage. Photocoagulation is indicated in cases with gross capillary non-perfusion or retinal neovascularisation. Early vitrectomy in non-resolving vitreous hemorrhage with or without endolaser depending on the retinal status should be the sheet anchor of managing these patients. The use of intravitreal VEGF inhibitors in preventing / regressing neo vascular retinal changes in eales disease should be studied and if effective will be a boon in treating these cases