Department of Sense Organs, Sapienza University of Rome, Head and Neck Department, Policlinico Umberto I University Hospital, Viale del Policlinico 155, 00161 Rome, Italy.
IRCCS Fondazione Bietti, 00198 Rome, Italy.
Medicina (Kaunas). 2023 Jan 14;59(1):169. doi: 10.3390/medicina59010169.
: Eales disease is a clinical syndrome affecting the mid-peripheral retina with an idiopathic occlusive vasculitis and possible subsequent retinal neovascularization. The disease can develop into visually threatening complications. : We report the case of a 40-year-old Caucasian male with a history of cocaine abuse who presented with blurred vision in the left eye (LE). Fundus examination showed vitreous hemorrhages, peripheral sheathing of venous blood vessels, areas of retinal neovascularization in the LE, and peripheral occlusive phlebitis in the right eye. The full serologic panel was negative except for the heterozygous mutation of factor V Leiden. Clinical and biochemical parameters suggested a diagnosis of Eales disease. Therapy with dexamethasone, 1 mg per kg per day, tapered down slowly over 4 months, and peripheral laser photocoagulation allowed a regression of clinical signs and symptoms. : This case shows an uncommon presentation of Eales disease associated with cocaine abuse. Both cocaine abuse and a thrombophilic pattern, as cofactors, might have sensitized the retinal microcirculation on the pathogenetic route to this retinal pathology. Furthermore, in view of this hypothesis, a thorough ocular and general medical history investigating drug abuse and coagulation disorders is recommended for ophthalmologists in such cases.
Eales 病是一种影响中周边视网膜的临床综合征，其特征为特发性闭塞性血管炎和随后可能出现的视网膜新生血管形成。该疾病可能发展为威胁视力的并发症。
我们报告了一例 40 岁白人男性病例，该患者有可卡因滥用史，表现为左眼视力模糊。眼底检查显示玻璃体积血、静脉血管周围鞘、左眼视网膜新生血管形成区和右眼周围闭塞性静脉炎。除了因子 V Leiden 的杂合突变外，全血清学检查均为阴性。临床和生化参数提示 Eales 病的诊断。采用地塞米松治疗，每天每公斤 1 毫克，在 4 个月内逐渐减少，同时进行周边激光光凝，使临床体征和症状得到缓解。
该病例显示了一种不常见的与可卡因滥用相关的 Eales 病表现。可卡因滥用和血栓形成倾向等合并因素可能通过视网膜病理学的发病途径使视网膜微循环敏感化。此外，鉴于这一假设，对于此类病例，眼科医生应进行全面的眼部和一般病史调查，以了解药物滥用和凝血障碍情况。
