Eales' disease with secondary coats'-like reaction: a case report

Area of Science:

• Ophthalmology
• Retinal Vascular Diseases
• Medical Case Reports

Background:

• Eales' disease involves retinal inflammation with phlebitis, non-perfusion, and neovascularization.
• Coats' disease is a retinal vasculopathy with telangiectasia and exudation.
• Both conditions primarily affect males and are idiopathic.

Observation:

• A 25-year-old male presented with unilateral blurred vision and decreased visual acuity.
• Fundoscopy revealed macular telangiectasia, peripheral vascular sheathing, and distal non-perfusion without exudation.
• Optical coherence tomography showed inner retinal thinning and minimal intraretinal fluid; fluorescein angiography confirmed leakage from aneurysms.

Findings:

• Diagnosis of Eales' disease with a secondary Coats'-like reaction was made after excluding other causes.
• FFA-guided laser photocoagulation was administered to areas of non-perfusion.
• The patient's condition and visual acuity remained stable over an 18-month follow-up period.

Implications:

• This case highlights an atypical presentation of Eales' disease.
• It underscores the possibility of a secondary Coats'-like reaction in Eales' disease.
• Recognizing such atypical presentations is crucial for accurate diagnosis and management of retinal vascular disorders.