Summary about Disease
Eales' disease is an idiopathic (unknown cause) obliterative peripheral retinal vasculopathy, primarily affecting young, healthy individuals. It is characterized by inflammation and blockage of blood vessels in the retina, leading to ischemia (lack of blood flow), neovascularization (abnormal blood vessel growth), and potentially, retinal hemorrhages, vitreous hemorrhage (bleeding into the clear gel that fills the eye), and retinal detachment. It can cause significant vision loss.
Symptoms
Symptoms can vary depending on the stage of the disease and can affect one or both eyes. Common symptoms include:
Floaters (small specks or clouds moving in your vision)
Blurred vision
Sudden vision loss (often due to vitreous hemorrhage)
Photopsia (flashes of light)
Eye pain (less common)
Causes
The exact cause of Eales' disease is unknown (idiopathic). Various hypotheses have been proposed, including:
Immune response: An autoimmune reaction against retinal tissue.
Tuberculosis: Though not definitively proven, some studies suggest a possible association with latent tuberculosis infection.
Free radical damage: Oxidative stress may play a role.
Genetic predisposition: While not strongly linked, a genetic component may contribute in some cases.
Medicine Used
Treatment strategies depend on the stage and severity of the disease. Common treatments include:
Corticosteroids: To reduce inflammation. They can be administered systemically (oral or intravenous) or locally (eye drops or injections).
Anti-VEGF injections: Vascular endothelial growth factor (VEGF) inhibitors can reduce neovascularization and leakage from abnormal blood vessels. (e.g., Bevacizumab, Ranibizumab, Aflibercept)
Laser photocoagulation (Panretinal photocoagulation or PRP): To destroy ischemic retina and reduce neovascularization.
Vitrectomy: Surgical removal of the vitreous gel, usually to remove blood from the eye and repair retinal detachments.
Tuberculosis treatment: If there's a confirmed or suspected association with tuberculosis.
Is Communicable
Eales' disease is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent Eales' disease, as the exact cause is unknown. However, general health measures are advisable:
Regular eye exams: Early detection and treatment are crucial.
Healthy lifestyle: Maintain a balanced diet, exercise regularly, and avoid smoking.
Management of underlying conditions: If associated with tuberculosis, ensure appropriate treatment.
Adherence to treatment plan: Follow your doctor's instructions carefully and attend all scheduled appointments.
How long does an outbreak last?
Eales' disease does not typically have "outbreaks" in the same way as an infectious disease. It is a chronic condition that can have periods of activity (inflammation, hemorrhages) and remission. The duration of active phases can vary significantly depending on the individual and the effectiveness of treatment. Untreated, the disease can progress over months or years, leading to significant vision loss.
How is it diagnosed?
Diagnosis of Eales' disease involves a comprehensive eye exam and several diagnostic tests:
Dilated fundus examination: To visualize the retina and blood vessels.
Fluorescein angiography (FA): A dye is injected into the bloodstream, and pictures are taken of the retinal blood vessels to identify areas of leakage, blockage, and neovascularization.
Optical coherence tomography (OCT): Provides detailed cross-sectional images of the retina to assess for edema, retinal thickness, and other abnormalities.
Visual field testing: To assess peripheral vision loss.
Blood tests: To rule out other possible causes of retinal vasculitis, such as autoimmune diseases or infections.
Tuberculin skin test or Interferon-Gamma Release Assay (IGRA): To screen for latent tuberculosis.
Timeline of Symptoms
The timeline of symptoms in Eales' disease can vary, but generally progresses as follows:
Early stages: Mild inflammation, asymptomatic or subtle symptoms like floaters.
Intermediate stages: Increased inflammation, retinal ischemia, early neovascularization, blurred vision, occasional floaters.
Late stages: Vitreous hemorrhage (sudden vision loss), retinal detachment, significant vision loss, and potential complications like neovascular glaucoma. The progression rate varies widely among individuals.
Important Considerations
Early diagnosis and treatment are crucial to prevent vision loss.
Long-term follow-up is necessary to monitor for recurrence and complications.
Patient education is essential for understanding the disease and adhering to treatment.
Ruling out other causes of retinal vasculitis is important for accurate diagnosis.
The role of tuberculosis in Eales' disease is still debated, and treatment for tuberculosis should be considered if there's a strong suspicion or confirmation of latent infection.
Visual prognosis can vary significantly depending on the severity of the disease and the response to treatment.