Eales Disease

  

A cruise-ship employee presents with loss of vision in the left eye for 4 days. Visual acuity in the right eye was 20/30 and counting fingers at 1 foot in the left eye. Slit lamp examination revealed 1+ cell and flare in the right eye and trace cell and flare in the left eye. Dilated fundus exam revealed bilateral periphlebitis and hemorrhages along vascular branches with vitreous hemorrhage in the left eye. Fluorescein angiography demonstrated bilateral peripheral capillary non-perfusion and late leakage. Laboratory evaluation was conducted, and revealed only a positive Quantiferon. The patient was diagnosed with bilateral hemorrhagic occlusive vasculitis secondary to Eales disease. The patient was begun on oral prednisone, rifampin, and valacyclovir. Panretinal photocoagulation and anti-VEGF injections were used to treat areas of retinal nonperfusion, and he underwent pars plana vitrectomy for non-clearing vitreous hemorrhage. Eales disease is a rare diagnosis of exclusion, consisting of peripheral obstructive retinal vasculopathy possibly secondary to mycobacterium tuberculosis exposure.

Presentation Date: 11/07/2024

Issue Date: 11/11/2024