Ishaq Mazher, Niazi Muhammad Khizar
Department of Ophthalmology, Military Hospital, Rawalpindi.
J Ayub Med Coll Abbottabad. 2002 Oct-Dec;14(4):22-5.
Eales disease is an idiopathic obliterative vasculopathy that commonly affects the peripheral retina of healthy young males characterized by recurrent vitreous haemorrhage. We did this study to evaluate the usefulness of prophylactic scatter photocoagulation in asymptomatic eyes of patients presenting with vitreous haemorrhage due to Eales Disease.
Ninety nine patients with Eales' Disease demonstrable on the basis of 3 mirror fundus exam and Florescein Fundus Angiography with vitreous haemorrhage underwent either Pan retinal photocoagulation or vitrectomy in a span of 3 years. Their fellow asymptomatic eyes were grouped on the basis of their visual acuity, fundus findings and FFA picture. Group A comprising of forty-three cases underwent PRP whereas forty-three cases of Group B were not given any treatment. These cases were followed for at least three years (range 38-42 months).
Out of the forty-three cases of group A, thirty-nine (83.82%) showed visual improvement as compared to only nine cases in Group-B (p < 0.001). Vitreous involvement was present in only 16 cases in Group-A as compared to 33 cases in Group-B. Twenty-eight cases of Group-B showed signs of persistence of disease process in the retina compared to 13 cases in Group-A (p < 0.005).
Prophylactic photocoagulation is an effective method of controlling the secondary complications in asymptomatic eyes of Eales disease especially if managed at an early stage. Regular checkup of peripheral retina by triple mirror examination should be performed in all asymptomatic fellow eyes of Eales disease to detect the disease process at an early stage and prevent further complications.
伊尔斯病是一种特发性闭塞性血管病,通常影响健康年轻男性的周边视网膜,其特征为反复玻璃体积血。我们开展这项研究以评估预防性散射光凝术对因伊尔斯病导致玻璃体积血患者无症状眼的有效性。
99例经三面镜眼底检查和荧光素眼底血管造影确诊为伊尔斯病且伴有玻璃体积血的患者在3年时间内接受了全视网膜光凝或玻璃体切除术。他们的对侧无症状眼根据视力、眼底表现和荧光素眼底血管造影图像进行分组。A组43例接受了全视网膜光凝,而B组43例未接受任何治疗。这些病例至少随访了3年(范围为38 - 42个月)。
A组43例中,39例(83.82%)视力有改善,而B组只有9例(p < 0.001)。A组仅有16例出现玻璃体受累,而B组有33例。B组28例视网膜显示有疾病进程持续的迹象,而A组为13例(p < 0.005)。
预防性光凝是控制伊尔斯病无症状眼继发性并发症的有效方法,尤其是在早期进行治疗时。对于所有伊尔斯病的无症状对侧眼,应通过三面镜检查定期检查周边视网膜,以便在疾病早期阶段检测到病变并预防进一步的并发症。