Raizada Kshitij, Tripathy Koushik
ASG Eye Hospital, BT Road, Kolkata, India
Eales disease classically presents with repeated vitreous hemorrhage in young adults. It is most commonly found in the Indian subcontinent. It commonly affects the peripheral fundus and is characterized by retinal vasculitis. In the year 1880, it was Sir Henry Eales, who first described the Eales disease in a cluster of young males, as idiopathic obliterative vasculopathy, which presented with recurrent vitreous hemorrhage in association with headache, constipation, and epistaxis. In such cases of retinal periphlebitis, systemic causes, including tuberculosis and sarcoidosis, should be ruled out. The clinical spectrum of Eales disease is divided into several stages, and the management is determined by the stage of the disease. Management includes intraocular and periocular steroids and oral corticosteroids, which are needed to control the activity of bilateral retinal vasculitis. Laser photocoagulation is needed in stages of retinal ischemia and neovascularization. Cases in which vitreous hemorrhage persists and does not resolve in several months, with or without retinal detachment need vitrectomy, the results of which are quite satisfactory. The role of antitubercular therapy in such cases without any other systemic focus is debatable and needs further evaluation.
伊尔斯病典型地表现为年轻成年人反复发生的玻璃体积血。它最常见于印度次大陆。它通常累及周边眼底,其特征为视网膜血管炎。1880年,亨利·伊尔斯爵士首次在一群年轻男性中描述了伊尔斯病,将其作为特发性闭塞性血管病,表现为反复玻璃体积血并伴有头痛、便秘和鼻出血。在这种视网膜静脉周围炎的病例中,应排除包括结核病和结节病在内的全身性病因。伊尔斯病的临床谱分为几个阶段,治疗方法取决于疾病的阶段。治疗包括眼内和眼周类固醇以及口服皮质类固醇,以控制双侧视网膜血管炎的活动。在视网膜缺血和新生血管形成阶段需要进行激光光凝治疗。玻璃体积血持续数月不消退,无论有无视网膜脱离的病例都需要进行玻璃体切除术,其效果相当令人满意。在没有任何其他全身病灶的此类病例中,抗结核治疗的作用存在争议,需要进一步评估。