A 24-year-old man presents with recurrent painless vitreous haemorrhage in the right eye. Fundoscopy of the left eye shows sheathing and sclerosis of peripheral retinal venules with areas of capillary non-perfusion in the extreme periphery. He has a chronic cough and positive Mantoux test. What is the MOST likely diagnosis?

• A Sickle cell retinopathy
• B Coats disease
• C Behcet disease
• D Eales disease ✓

Explanation

Eales disease is an idiopathic obliterative perivasculitis affecting predominantly young adult males, classically reported from the Indian subcontinent, with a recognised association with tuberculin hypersensitivity. It progresses through venous inflammation, peripheral ischaemia, and neovascularisation causing repeated vitreous haemorrhage. Behcet causes occlusive vasculitis but with recurrent uveitis and oral ulcers, sickle cell retinopathy shows sea fan neovascularisation in a patient with sickling haemoglobinopathy, and Coats affects young boys with telangiectatic vessels and massive exudation.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.