USEFULNESS OF LASER PHOTOCOAGULATION IN MANAGING ASYMPTOMATIC EYES OF EALES` DISEASE
AbstractBackground: 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. Methods: 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). Results: 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). Conclusion: 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.KEYWORDS: Eales disease, Photocoagulation, Retinal neovascularization, Vitreous haemorrhage.
Biswas J, Sharma T, Gopal L, Madhavan HN, Sulochana KN, Ramakrishnan S. Eales disease-An Update. Surv Ophthalmol 2002; 47 (3): 197-214.
Das T, Biswas J. Kumar A. Eales disease. Indian J Ophthalmol 1994; 42: 3-18.
Gadkari SS, Kamdar PA, Jehangir RP. Pars plana vitrectomy in vitreous haemorrhage due to Eales disease. Indian J Ophthalmol 1992; 10: 35-37.
Patnaik B, Nagpul PN, Namperumalsamy P, Kalsi R. Eales disease-clinical features, pathophysiology, etiopathogenesis. Ophthalmol Clin North Am 1998; 11: 601-617.
Abraham C, Baig SM, Badrinath SS. Eales disease. Proc All India Ophthalmol Soc 1977; 33: 223-229.
Donders PC. Eales disease. Doc Ophthalmol 1958; 12: 1-105.
Biswas J, Therese L, Madhavan HN. Use of PCR in detection of mycobacterium tuberculosis complex DNA from vitreous sample of Eales Disease. Br J Ophthalmol 1999; 83: 994-996
Kimura SJ, Carriker FR, Hogen MJ. Retinal vasculitis with intraocular haemorrhage. Classification and results of special studies. Arch Ophthalmol 1956; 56: 361-365.
Saxena S, Rajasingh J, Biswas S. Cellular immune response to retinal S-antigen and interphotoreceptor retinoid-binding protein fragments in Eales disease patients. Pathobiology 1999; 67: 39-44.
Biswas J, Narain S, Roy S, Madhavan HN. HLA Association in Eales disease. Invest Ophthalmol Vis Sci 1996; 36: S363.
Atmaca LS, Idli A, Gunduz K. Visualisation of retinal vasculitis in Eales disease. Ocul Immunol Inflamm 1993;1: 49-54.
Renie WA, Murphy RP, Anderson KC. The evaluation of patients with Eales disease. Retina 1983; 3: 243-248.
Nagpal PN, Sharma RK, Joshi BS, Patel AM. Management of Eales disease-analysis of 800 cases (1,214 eyes). Asia Pac J Ophthalmol 1998; 10: 11-17.
Badrinath SS, Gopal L, Sharma T. Vitreoschisis in Eales disease: pathogenic role and significance in surgery. Retina 1999; 19: 51-54.
Theodossisadis G Fluorescein angiography in Eales disease Am J Ophthalmol 1970; 69: 271-277.
Jalali S, Das T. Eales disease. In: Dutta LC, ed. Modern Ophthalmology. New Delhi: Jaypee Brothers Medical Publishers, 2000; 2: 704-705.
Howe LJ, Stanford MR, Edelsten C, Graham EM. The efficacy of systemic corticosteroids in sight-threatening retinal vasculitis. Eye 1994; 8: 443-447.
Magargal LE, Walsh AW, Magargal HO, Robb-Doyle E. Treatment of Eales Disease with scatter laser photocoagulation. Ann Ophthalmol 1989; 21: 300-304.
Obana A, Miki T, Matsumoto M. An experimental and clinical study of chorioretinal photocoagulation using a frequency-doubled Nd: YAG laser. Nippon Ganka Gakai Zasshi 1993; 97: 1040-1046.
Gadkari SS, Kamdar PA, Jehangir RP, Shah NA, Adrianwala SD. Pars plana vitrectomy in vitreous haemorrhage due to Eales` disease. Indian J Ophthalmol 1992; 40: 35-37.
Stephen CG, Robert PM. Eales` Disease. In : Jackobiec FA, Albert DM, eds. Principles and Practice of Ophthalmology: Clinical practice. Philadelphia: WB Saunders Company, 1994; 58: 791-795.
Meyer SG. Eales disease, treatment with light coagulation. Mod Probl Ophthalmol 1966; 4: 10-14.
Pahwa JM, Garg MP. Eales disease-its clinical course and treatment by photocoagulation-a review of 100 cases. Eye, Ear, Nose, Throat Monthly; 1968; 47: 174-178.
Spitznas M. Eales` disease: clinical picture and treatment with photocoagulation. In L`Esperance FA, ed. Current diagnosis and management of chorioretinal diseases. St Louis: CV Mosby Company, 1977; 4:12-16.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.