Saxena Sandeep, Kumar Dipak
Department of Ophthalmology, King George's Medical University, Lucknow, India.
Indian J Ophthalmol. 2007 Jul-Aug;55(4):267-9. doi: 10.4103/0301-4738.33038.
A retrospective tertiary care center-based study was undertaken to evaluate the visual outcome in Eales' disease, based on a new classification system, for the first time.
One hundred and fifty-nine consecutive cases of Eales' disease were included. All the eyes were staged according to the new classification: Stage 1: periphlebitis of small (1a) and large (1b) caliber vessels with superficial retinal hemorrhages; Stage 2a: capillary non-perfusion, 2b: neovascularization elsewhere/of the disc; Stage 3a: fibrovascular proliferation, 3b: vitreous hemorrhage; Stage 4a: traction/combined rhegmatogenous retinal detachment and 4b: rubeosis iridis, neovascular glaucoma, complicated cataract and optic atrophy. Visual acuity was graded as: Grade I 20/20 or better; Grade II 20/30 to 20/40; Grade III 20/60 to 20/120 and Grade IV 20/200 or worse. All the cases were managed by medical therapy, photocoagulation and/or vitreoretinal surgery. Visual acuity was converted into decimal scale, denoting 20/20=1 and 20/800=0.01. Paired t-test / Wilcoxon signed-rank tests were used for statistical analysis.
Vitreous hemorrhage was the commonest presenting feature (49.32%). Cases with Stages 1 to 3 and 4a and 4b achieved final visual acuity ranging from 20/15 to 20/40; 20/80 to 20/400 and 20/200 to 20/400, respectively. Statistically significant improvement in visual acuities was observed in all the stages of the disease except Stages 1a and 4b.
Significant improvement in visual acuities was observed in the majority of stages of Eales' disease following treatment. This study adds further to the little available evidences of treatment effects in literature and may have effect on patient care and health policy in Eales' disease.
首次开展一项基于三级医疗中心的回顾性研究，以基于一种新的分类系统评估伊尔斯病的视力预后。
纳入159例连续的伊尔斯病病例。所有患眼均根据新分类进行分期：1期：小口径（1a）和大口径（1b）血管的周边静脉炎伴视网膜浅层出血；2a期：毛细血管无灌注，2b期：其他部位/视盘新生血管形成；3a期：纤维血管增殖，3b期：玻璃体积血；4a期：牵拉性/合并孔源性视网膜脱离，4b期：虹膜新生血管、新生血管性青光眼、并发性白内障和视神经萎缩。视力分级为：Ⅰ级：20/20或更好；Ⅱ级：20/30至20/40；Ⅲ级：20/60至20/120，Ⅳ级：20/200或更差。所有病例均采用药物治疗、光凝和/或玻璃体视网膜手术治疗。视力转换为小数记录，20/20 = 1，20/800 = 0.01。采用配对t检验/威尔科克森符号秩检验进行统计分析。
玻璃体积血是最常见的表现特征（49.32%）。1至3期以及4a期和4b期病例的最终视力分别为20/15至20/40；20/80至20/400和20/200至20/400。除1a期和4b期外，在疾病的所有阶段均观察到视力有统计学意义的改善。
治疗后伊尔斯病的大多数阶段视力有显著改善。本研究进一步补充了文献中关于治疗效果的少量现有证据，可能对伊尔斯病患者的护理和卫生政策产生影响。
