Treatment Outcomes in Eales’ Disease with Vitreous Hemorrhage at Tertiary Center in Southern Thailand


  • Thada Tantisarasart Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Patama Bhurayanontachai Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.



conservative treatment, Eales’ disease, laser photocoagulation, outcome, pars plana vitrectomy, vitreous hemorrhage


Objective: To assess the anatomical and functional outcomes of Eales’ disease with secondary vitreous hemorrhage after conservative treatment and/or pars plana vitrectomy (PPV).

Material and Methods: A retrospective chart review of patients, diagnosed with Eales’ disease, at Songklanagarind Hospital from January 2003 to December 2017 was performed. Thirty-two eyes, from 28 patients, with secondary vitreous hemorrhage underwent conservative treatment and/or PPV; depending on the degree of vitreous hemorrhage, clinician consideration and patient’s decision.

Results: Twenty-five eyes, with low-grade (grade 1-3) and dense (grade 4) vitreous hemorrhage, initially underwent conservative treatment; in which 64.0% achieved final best corrected visual acuity (BCVA) ≥20/70 and 56.0% achieved final BCVA ≥20/40 with complete resolution of vitreous hemorrhage. However, 8 eyes eventually required additional PPV as a result of non-resolving vitreous hemorrhage. Alternatively, 7 eyes with dense vitreous hemorrhage (grade 4) at the presentation, preferred PPV as primary treatment, which resulted in final BCVA ≥20/70 in 57.0% and final BCVA ≥20/40 in 43.0%. Post vitrectomy complications included; cataract progression (52.9%), high intraocular pressure (35.3%), epiretinal membrane (23.5%), and rhegmatogenous retinal detachment (17.6%).

Conclusion: Anatomical and functional outcomes of Eales’ disease with vitreous hemorrhage were relatively good following either conservative treatment or PPV. Each treatment option offered both advantages and disadvantages. The risks and benefits of each treatment option should be discussed with each individual patient to achieve the optimal outcome. Due to being a less invasive procedure, conservative treatment should be initially performed with close monitoring. In the minority of patients, vitrectomy still plays an important role to improve visualization and enable laser photocoagulation, despite potential risk of cataract progression.


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Das T, Pathengay A, Hussain N, Biswas J. Eales’ disease: diagnosis and management. Eye 2010;24:472–82.

Biswas J, Sharma T, Gopal L, Madhavan HN, Sulochana KN, Ramakrishnan S. Eales' disease-an update. Surv Ophthalmol 2002;47:197–214.

Saxena S, Rajasingh J, Biswas S, Kumar D, Shinohara T, Singh VK. Cellular immune response to retinal S-antigen and interphotoreceptor retinoid-binding protein fragments in Eales’ disease patients. Pathobiology 1999;67:39–44.

Gupta P, Biswas J. Further evidence of the association of latent Mycobacterium tuberculosis in Eales’ disease. Int Ophthalmol 2021;41:901–6.

Muthukkaruppan V, Rengarajan K, Chakkalath HR, Namperumalsamy P. Immunological status of patients of Eales’ disease. Indian J Med Res 1989;90:351–9.

Agrawal R, Gunasekeran DV, Gonzalez-Lopez JJ, Cardoso J, Gupta B, Addison PKF, et al. Peripheral retinal vasculitis: analysis of 110 consecutive cases and a contemporary reappraisal of tubercular etiology. Retina 2017;37:112–7.

Madhavan HN, Therese KL, Doraiswamy K. Further investigations on the association of Mycobacterium tuberculosis with Eales’ disease. Indian J Ophthalmol 2002;50:35–9.

Biswas J, Ravi RK, Naryanasamy A, Kulandai LT, Madhavan HN. Eales’ disease - current concepts in diagnosis and management. J Ophth Inflamm Infect 2013;3:11.

Pathanapitoon K, Rothova A, Apinyawasisuk S, Kunavisarut P. Clinical features and etiology of retinal vasculitis in Northern Thailand. Indian J Ophthalmol 2013;61:739-42.

Saxena S, Kumar D. New classification system-based visual outcome in Eales’ disease. Indian J Ophthalmol 2007;55:267.

Biswas J, Reesha KR, Pal B, Gondhale HP, Sitaula RK. Longterm outcomes of a large cohort of patients with Eales’ disease. Ocul Immunol Inflamma 2018;26:870–6.

El-Asrar AMA, Al-Kharashi SA. Full panretinal photocoagulation and early vitrectomy improve prognosis of retinal vasculitis associated with tuberculoprotein hypersensitivity (Eales’ disease). Br J Ophthalmol 2002;86:1248–51.

Patwardhan SD, Azad R, Shah BM, Sharma Y. Role of intravitreal Bevacizumab in Eales' disease with dense vitreous hmoerhage. Retina 2011;31:866–70.

Dehghan MH, Ahmadieh H, Soheilian M, Azarmina M, Mashayekhi A, Naghibozakerin J. Therapeutic effects of laser photocoagulation and/or vitrectomy in Eales’ disease. Eur J Ophthalmol 2005;15:379-83.

Saxena S, Kumar D. A new staging system for idiopathic retinal periphlebitis. Eur J Ophthalmol 2004;14:236–9.

Grillone LR LR, Gow JA. Development and implementation of a vitreous hemorrhage grading scale. Retinal Physician 2006;3:S1–8.

Kumar A, Tiwari HK, Singh RP, Verma L, Prasad N. Comparative evaluation of early vs. deferred vitrectomy in Eales’ disease. Acta Ophthalmol Scand 2000;78:77–8.

Connors D, Shah G, Blinder K, Dang S. Early versus delayed vitrectomy for nondiabetic vitreous hemorrhage. J Vitreoretin Dis 2018;2. doi: 10.1177/2474126418758771.

Khanduja S, Gupta S, Sinha S, Venkatesh P, Vohra R, Garg S. Surgical outcomes of minimally invasive vitrectomy surgery in Eales’ disease. Nep J Oph 2013;5:182–9.

Shanmugam MP, Badrinath SS, Gopal L, Sharma T. Long term visual results of vitrectomy for Eales' disease complications. Int Ophthalmol 1998;22:61-4.




How to Cite

Tantisarasart T, Bhurayanontachai P. Treatment Outcomes in Eales’ Disease with Vitreous Hemorrhage at Tertiary Center in Southern Thailand. J Health Sci Med Res [Internet]. 2021 Oct. 18 [cited 2022 Jun. 29];40(3):359-66. Available from:



Original Article