Title

EALES DISEASE: CASE REPORT USING ULTRA-WIDE FIELD FLUORESCEIN ANGIOGRAPHY

Summary

Purpose: to report a case of peripheral vascular abnormalities using a ultra-wide field retinal device. Methods: case report. Case Report: a 59 year-old, Caucasian, female complained about floaters on her right eye on January, 2016. Past medical history: major depression, dyslipidemia, pre-DM, systemic high blood pressure, and chronic arthralgia. Past ocular history was unremarkable. Ophthalmologic examination showed 20/20 visual acuity on both eyes, anterior segment unremarkable and dilated fundus examination was positive for a Weiss ring. No treatment was advised. On October, 2018, she complained about sudden visual loss on OS (BCVA 20/100) with floaters. Fundus examination showed a light vitreous hemorrhage with small intra-retinal hemorrhages at the end of de superior-temporal arcade. One month later, the BCVA was 20/20 on both eyes, and fundus examination showed terminal ghost venules on the temporal side in both eyes. Wide-field fluorescein angiography showed temporal peripheral areas of non-perfusion in both eyes with vasculo-adaptive fenomena on OS. Systemic work-up, including blood cell count, hemoglobin electrophoresis, fasting glucose, Hb1AC, ANF, RF, ANCA, anti-toxo, -hiv 1 and 2, -HCV, HbsAg, VDRL, ACE, Serum Calcium, PPD, Chest X-ray were performed and came all within the normal range. Discussion: considering the general diagnosis of peripheral retinal ischemia with vitreous hemorrhage episodes and a negative systemic work up, Eales' disease was diagnosed. Others differential diagnosis will be discussed, such as idiopathic retinal vasculitis, diabetic retinopathy, systemic vasculitis, syckle cell retinopathy, and myeloid chronic leukemia.

Area

CLINICAL CASE

Authors

Jean Vítor de Aguiar Lédo Coutinho, Arnaldo Furman Bordon, Ícaro Augusto Godinho, Patrícia Bortolai