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Eales Disease Workup

  • Author: Daniel B Roth, MD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Aug 21, 2014
 

Laboratory Studies

No clinical laboratory studies are available to confirm the diagnosis of Eales disease, as it is a diagnosis of exclusion. However, laboratory studies are necessary to exclude other similar entities. See the following:

  • Blood glucose or fasting blood glucose to rule out diabetes mellitus
  • Complete blood count to rule out hemoglobinopathies
  • Sickle cell preparation and serum protein electrophoresis to rule out sickle cell disease
  • Angiotensin converting enzyme and lysozyme to rule out sarcoidosis
  • Antinuclear antibody, rheumatoid factor, and erythrocyte sedimentation rate to rule out collagen vascular disease
  • Tuberculin skin testing may be useful, as patients with Eales disease have a higher incidence of tuberculin hypersensitivity, despite the absence of a history of tuberculosis.
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Imaging Studies

Fluorescein angiography (FA) can be useful to determine the nature of the microvascular abnormalities associated with Eales disease. Neovascularization and exudative sheathing of vessels will leak fluorescein dye. The area and degree of nonperfusion can be determined on FA and help delineate where to apply laser photocoagulation, when indicated. Note the image below.

Eales disease. Fluorescein angiogram of late leaka Eales disease. Fluorescein angiogram of late leakage from peripheral retinal neovascularization.

Echographic evaluation often is useful to evaluate the retina in the setting of vitreous hemorrhage. When the details of the fundus are obscured, ultrasound can determine the presence or absence of a retinal detachment or vitreoretinal traction.

Chest radiography may be considered to rule out sarcoidosis or a history of tuberculosis, in the setting of a positive tuberculin skin test.

Magnetic resonance imaging (MRI) of the brain may reveal multifocal white matter abnormalities, but this study probably is not warranted in the absence of neurologic symptoms.

Optical coherence tomography (OCT) is a useful modality to image the macular morphology and architecture. Any possible cystoid changes in the macula contributing to visual loss may be detected with OCT.

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Other Tests

Studies have found an increased level of oxidation and peroxidation products in vitreous samples from patients with Eales disease (ie, an increased amount of thiobarbituric acid reacting substances). A decreased level of antioxidant enzymes also has been found in vitreous samples from patients with Eales disease (ie, a decreased amount of reduced glutathione, superoxide dismutase, and glutathione peroxidase).[11, 12]

Hearing and balance should be tested formally, as patients with Eales disease may have associated vestibuloauditory dysfunction.

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Contributor Information and Disclosures
Author

Daniel B Roth, MD Assistant Professor, Department of Ophthalmology, Retina Vitreous Center, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School

Daniel B Roth, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Society of Retina Specialists, Retina Society, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Howard F Fine, MD, MHSc Partner, Associated Retina Consultants, Retina Vitreous Center, PA; Co-founder and Chairman of Scientific Advisory Board, Auris Surgical Robotics, Inc

Howard F Fine, MD, MHSc is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, Association for Research in Vision and Ophthalmology, American Society of Retina Specialists

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Russell P Jayne, MD Consulting Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Retina Specialists

Disclosure: Nothing to disclose.

References
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Eales disease. Fundus photo of the peripheral retina, revealing vascular tortuosity and peripheral retinal neovascularization.
Eales disease. Fluorescein angiogram of late leakage from peripheral retinal neovascularization.
 
 
 
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