EALES HASTALIĞINDA KLİNİK SEYİR VE LASER TEDAVİSİNİN ETKİNLİĞİ

Öz

Kliniğimiz retina bölümünde idiopatik periferik retinal vasküliti Eales hastalığı olan 18 hastanın 28 gözü incelendi. Olguların 16’ sı %88.8 erkek, 2’ si %11.1 kadın olup, yaş ortalamaları 48.2 idi. Ortalama takip süresi 36.3 ay 1-93 ay idi. Her hastaya tam oftalmolojik muayene yapıldı ve bütün hastaların flöresein anjiografileri çekildi. Olguların %55.5’ i bilateraldi. Bütün hastalarda ağrısız görme azalması mevcuttu. Süperior temporal kadran en çok tutulan retina alanıydı %64.3 . Olguların %78.5’ inde vitreus hemorajisi vardı. Flöresein anjiografisi bulguları; %89.3 vaskülit, %89.3 neovaskülarizasyon ve %85.7 iskemi olarak saptandı. Yirmi iki olguya laser fotokoagülasyon tedavisi uygulandı.Üç olguya pars plana vitrektomi yapıldı. İki olguda postoperatif görme keskinliği artarken,1 olguda total retina dekolmanı ve fitizis gelişti. Hastaların %83.4’ ünde laser fotokoagülasyon ile görme korunmuş veya artmıştır. Bu oranın erken tanı ve tedavi ile artırılabilmesi mümkündür

Anahtar Kelimeler

• Eales hastalığı,laser fotokoagülasyon

CLINICAL COURSE AND EFFECTIVITY OF LASER TREATMENT IN EALES DISEASE

Öz

In the retina department of our clinic we investigated 28 eyes of 18 patients with idiopathic peripheral retinal vasculitis Eales’ disease . The study group was consisted of 16 males 88.8% and 2 females 11.1% with a mean age of 48.2 years range 28-69 years . Mean follow-up was 36.3 months range 1-93 months . A complete ophthalmic examination was performed in each patient and fluorescein angiography were done in all patients. 55.5% of the cases were bilateral. Decrease of visual acuity without pain was present in all patients. Superior temporal quadrant was most affected 64.3% . 78.5% of the cases had vitreous hemorrhage. Findings of fluorescein angiography were 89.3% vasculitis, 89.3% neovascularization and 85.7% ischemia. Twenty-two cases were treated with laser photocoagulation. Pars plana vitrectomy was performed in three cases. Post-operative visual acuity increased in two patients and there was total retinal detachment and phthisis in one case. Visual acuity unchanged or increased in 83.4% of the patients who had been treated with laser photocoagulation. This proportion can be increased with early diagnosis and treatment

Anahtar Kelimeler

• Eales disease,laser photocoagulation

Kaynakça

1. Shanmugam MP, Badrinath SS, Gopal L, Sharma T: Long term visual results of vitrectomy for Eales disease complications. International Ophthalmology 1998, 22: 61-64.
2. Kumar A, Tiwari HK, Singh RP, Verma L, Prasad N: Comperative evaluation of early vs deferred vitrectomy in Eales’ disease. Acta Ophthalmologica scandinavica 2000, 78:77-78.
3. Katz B, Wheeler D, Weinreb RN, Swenson MR: Eales’ disease with central nervous system infarction. Ann Ophthalmol 1991, 23:460-63.
4. Temel M, Bayraktar MZ, Karagül S, Yıldırım E, Ergin A. Eales hastalığında sonuçlarımız. TOD XXIV. Ulusal Kongre Bülteni Ankara 1990:79-81.
5. Magargal LE, Walsh AW, Magargal HO, Rob Doyle E. Treatment of Eales disease with scatter laser photocoagulation. Ann Ophthalmol 1989;21:300-302
6. Bhooma V, Julochana KN, Biswas J, Ramakrishnan S: Eales’ disease: Accumulation of reactive oxyggen intermediates and lipid peroksidases and decrease of antioxidants causing inflammation, neovascularization and retinal damage. Current Eye Research 1997;16:91-95.
7. Rengarajan K, Mathukkaruppan VR, Namperumalsamy P. Biochemical analysis of serum proteins from Eales patients. Current Eye Research 1989; 8(12):1259-1269.
8. Sen DK, Sarin GS, Ghosh B, Acharya NR, Gurha N. Serum alpha 1 glycoprotein levels in patients with idiopathic peripheral retinal vasculitis (Eales’ disease). Acta Ophthalmol 1992; 70:515-517.

9. Akduman L, Or M, Akata F, Önol M, Hasanreisoğlu B. Eales hastalığı tanısıyla pars plana vitrektomi uygulanan olgular ve sonuçları. TOD XXIV. Ulusal Kongre Bülteni Ankara, 1990:74-78.
10. Badrinath SS, Gopal L, Sharma T, Parikh S, Shanmugam MP, Bhende P, Biswas J. Vitreoschisis in Eales disease:Pathogenic role and significance in surgery. Retina,The J of Retinal and Vitreous Diseases 1999;19(1):51-54.
11. Biswas J, Mukesh BN, Narain S,Madhavan SR&HN. Profiling of human leucocyte antigens in Eales’ disease. International Ophthalmology 1998; 21:277-281.