A 24-year-old man presents with sudden painless loss of vision in the left eye due to vitreous haemorrhage. Fundus examination of the right eye shows peripheral retinal venous occlusion with perivascular sheathing, capillary non-perfusion on fluorescein angiography, and neovascularisation at the junction of perfused and non-perfused retina. Mantoux test is strongly positive. The most likely diagnosis is:
- A Sickle cell retinopathy
- B Eales disease ✓
- C Ocular toxocariasis
- D Coats disease
Correct answer: B. Eales disease
Explanation
Eales disease is idiopathic obliterative peripheral retinal vasculitis affecting predominantly young males, with a well-documented hypersensitivity association with tuberculosis antigen, hence the strong Mantoux reactivity. It classically progresses through periphlebitis, capillary non-perfusion, neovascularisation, and recurrent vitreous haemorrhage. Coats disease and toxocariasis affect younger children without venous sheathing, and sickle retinopathy shows sea-fan neovascularisation with a positive haemoglobin electrophoresis.
Reference: Parsons' Diseases of the Eye, 23rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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