[Eales disease: a case report in Burkina Faso]

Area of Science:

• Ophthalmology
• Immunopathology
• Infectious Diseases

Background:

• Eales disease is a rare, idiopathic inflammatory condition affecting the peripheral retina, primarily characterized by recurrent vitreous hemorrhage.
• Its etiology remains largely unknown, but associations with tuberculosis and other immune-mediated processes have been suggested.
• Geographic distribution and clinical presentation can vary significantly across different populations.

Observation:

• A 21-year-old male in Burkina Faso presented with acute vision decrease, myodesopsia, vitreous hemorrhage, and retinal phlebitis in the right eye.
• The left eye exhibited phlebitis, retinal hemorrhages, vascular occlusion, and retinal ischemia.
• Tuberculin Skin Test (TST) was positive, but Mycobacterium tuberculosis was not isolated.

Findings:

• The case represents the first documented instance of Eales disease in Burkina Faso, expanding its known geographic prevalence.
• Clinical findings included severe unilateral vision impairment with characteristic retinal vascular inflammation and hemorrhage.
• While TST was positive, direct microbiological confirmation of tuberculosis was not achieved, suggesting a complex immunopathological basis.

Implications:

• This case underscores the importance of considering Eales disease in the differential diagnosis of unexplained retinal vasculitis, particularly in endemic regions.
• It highlights the need for comprehensive diagnostic workups, including immunological and microbiological investigations.
• Multimodal treatment strategies, including anti-tuberculosis therapy, corticosteroids, laser photocoagulation, and surgery, may be necessary for managing Eales disease.