B M Stoffelns1, C Kramann, K Schoepfer. 1. Augenklinik der Johannes-Gutenberg-Universität, Mainz. stoffelns@augen.klinik.unimainz.de
Abstract
BACKGROUND: Eales' disease is an uncommon vasoproliferative retinal disease affecting otherwise healthy young men. We report on our treatment results in a large patients group with long-term follow-up. PATIENTS AND METHODS: The treatment results in 50 eyes (35 patients) with Eales' disease, that were consecutively treated from May 1995 to August 2005, were analysed retrospectively. Recorded data included age, sex, race, association of systemic disease, medications, laboratory evaluation and the surgical treatment. Mean follow-up was 5.8 years (minimum: 3.2, maximum: 8.6 years). RESULTS: Systemic and laboratory evaluations detected a factor V Leiden mutation (4x), vestibuloauditory problems (1x) and migraine (1x). 10 eyes with peripheral non-perfusion, teleangiectasia and mild neovascularisations were treated by scatter laser photocoagulation alone. 18 eyes with advanced neovascularisations/vitreous haemorrhages received cryocoagulation too. 14 eyes with persistent or recurrent bleedings despite coagulation therapy and/or development of tractional retinal detachment were treated by vitrectomy. 5 of them received a silicone oil endotamponade. All eyes could be stabilised without further bleedings. Visual acuity increased in 25 eyes. Only 5 eyes showed a visual loss. The visual results (rate of improvements and the stages of visual acuity as well) were the best in those eyes that received vitrectomy. CONCLUSIONS: These results suggest that early retinal laser and cryocoagulation and - if necessary - vitrectomy in due time may led to a stabilised retina without further bleedings and visual improvement too. Coagulopathy could play a role in the pathogenesis of Eales' disease.
BACKGROUND:Eales' disease is an uncommon vasoproliferative retinal disease affecting otherwise healthy young men. We report on our treatment results in a large patients group with long-term follow-up. PATIENTS AND METHODS: The treatment results in 50 eyes (35 patients) with Eales' disease, that were consecutively treated from May 1995 to August 2005, were analysed retrospectively. Recorded data included age, sex, race, association of systemic disease, medications, laboratory evaluation and the surgical treatment. Mean follow-up was 5.8 years (minimum: 3.2, maximum: 8.6 years). RESULTS: Systemic and laboratory evaluations detected a factor V Leiden mutation (4x), vestibuloauditory problems (1x) and migraine (1x). 10 eyes with peripheral non-perfusion, teleangiectasia and mild neovascularisations were treated by scatter laser photocoagulation alone. 18 eyes with advanced neovascularisations/vitreous haemorrhages received cryocoagulation too. 14 eyes with persistent or recurrent bleedings despite coagulation therapy and/or development of tractional retinal detachment were treated by vitrectomy. 5 of them received a silicone oil endotamponade. All eyes could be stabilised without further bleedings. Visual acuity increased in 25 eyes. Only 5 eyes showed a visual loss. The visual results (rate of improvements and the stages of visual acuity as well) were the best in those eyes that received vitrectomy. CONCLUSIONS: These results suggest that early retinal laser and cryocoagulation and - if necessary - vitrectomy in due time may led to a stabilised retina without further bleedings and visual improvement too. Coagulopathy could play a role in the pathogenesis of Eales' disease.