A 24-year-old man presents with recurrent vitreous hemorrhage in the right eye. Fundus fluorescein angiography shows obliteration of peripheral retinal capillaries with perivascular sheathing and leakage from peripheral veins, along with neovascularization at the junction of perfused and non-perfused retina. Mantoux test is strongly positive. The most likely diagnosis is:
- A Sickle cell retinopathy
- B Behcet disease
- C Ocular sarcoidosis
- D Eales disease ✓
Explanation
Eales disease is an idiopathic obliterative perivasculitis affecting predominantly young Indian males, classically involving the peripheral retina with venous sheathing, capillary non-perfusion, and neovascularization leading to repeated vitreous hemorrhage. Its frequent association with tuberculosis hypersensitivity is well recognized in Indian practice, hence the positive Mantoux supports it. Sarcoid produces granulomatous uveitis with candle-wax drippings, Behcet gives panuveitis with occlusive vasculitis of both arteries and veins, and sickle retinopathy occurs in patients with sickle hemoglobinopathy.
Reference: Parsons' Diseases of the Eye, 23rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.