Eales' Disease

A patient presented with one month of blurred vision and floaters in the left eye. Visual acuity was 20/20 in the right eye and 20/70 in the left eye. Slit lamp exam was remarkable for a quiet anterior chamber and 2+ vitreous cell in both eyes. Dilated fundus exam demonstrated bilateral sectoral vascular sheathing and hemorrhages. Optical coherence tomography illustrated central cystoid macular edema in the left eye only, and fluorescein angiography highlighted capillary drop out and active sectoral vasculitis in both eyes. Serum testing was notable for positive quantiferon; infectious and inflammatory workup was otherwise negative. A presumed diagnosis of Eales' disease was made and the patient was started on oral prednisone with improvement in vasculitis bilaterally. However, the patient experienced rebound vasculitis with prednisone taper and required an intravitreal steroid injection in the left eye.

Presentation Date: 07/18/2024

Issue Date: 08/09/2024