Massive hemorrhagic retinal detachment during radial optic neurotomy

Background We encountered obvious arterial bleeding from the incision site during radial optic neurotomy (RON) in a 55-year-old woman with central retinal vein occlusion (CRVO) and report the findings herein. Case report The patient initially demonstrated a retinal hemorrhage and macular edema due to a left CRVO. Her corrected visual acuity was 0.5 OS. Since her symptoms did not improve and were aggravated, even though she received an oral anticoagulant drug orally, RON was performed 2 months after the onset of symptoms. During surgery, obvious arterial bleeding started from the RON incision site and it was not arrested although the infusion bottle was fully elevated. However, a subsequent infusion of liquid perfluoro-carbon successfully stopped the bleeding by direct pressure. Hemorrhagic retinal detachment occurred in the nasal quadrant and postoperative vitreous hemorrhage was treated surgically. The hemorrhagic retinal detachment was gradually absorbed and replaced by fibrous scar tissue. Two years after the surgery, no expansion of retinal detachment has been observed and corrected visual acuity is being maintained at 0.2 OS. Conclusion We conclude that RON for CRVO carries a risk of arterial bleeding and that infusion of liquid perfluoro-carbon seems to be effective to arrest arterial bleeding from the RON site.     

视网膜光凝术治疗视网膜静脉阻塞所致玻璃体积血的临床体会

目的:应用视网膜光凝术治疗视网膜静脉阻塞(RVO)所致的玻璃体积血,观察其保存视力、阻止病变发展为增殖性视网膜病变的临床效果。方法:选择RVO致玻璃体积血患者15例15眼,根据出血量多少决定光凝治疗时机,逐步完成全部阻塞区的激光治疗;术后观察视力、出血吸收及新生血管性青光眼消退等情况。结果:患者15例完成光凝时间历时1wk~6mo,光凝次数1~8次。14例玻璃体积血全部吸收,视力稳定或提高,达到临床治愈;1例发生反复出血,未愈;2例新生血管性青光眼消退。结论:对于适当病例,视网膜光凝术可有效治疗RVO所致玻璃体积血,并使已发生的继发性青光眼消退。     

视网膜光凝联合雷珠单抗玻璃体内注射治疗视网膜中央静脉阻塞

目的：研究氩激光视网膜光凝联合雷珠单抗玻璃体内注射治疗缺血型视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)伴发黄斑水肿及视网膜新生血管的临床疗效。

方法：回顾性分析2012-01/2013-05就诊于我院眼科确诊的缺血型CRVO 24例24眼患者行氩激光视网膜光凝联合雷珠单抗玻璃体内注射治疗。观察治疗前及治疗后1wk; 1,3,6mo的最佳矫正视力、眼压、眼底病变情况,治疗前和治疗后1,3,6mo的眼底荧光血管造影(FFA)表现和光学相干断层扫描(OCT)测量黄斑中心凹视网膜厚度(CMT)的改变。

结果：随诊时间大于6mo。20例(83%)患者视力有不同程度提高,其中17例(71%)患者黄斑水肿明显减轻或消失; 4例患者视力维持于就诊时水平。1例治疗前有虹膜新生血管,治疗后1mo虹膜新生血管消退无继发新生血管性青光眼发生。

结论：氩激光视网膜光凝联合雷珠单抗玻璃体内注射治疗缺血型CRVO可有效提高视力,促进视网膜出血、渗出及水肿的吸收,同时可减少视网膜静脉阻塞引起的新生血管,对预防继发性新生血管性青光眼的发生有明显效果。     

增生性糖尿病视网膜病变手术后视力光感或无光感发生的相关因素分析

目的探讨增生性糖尿病视网膜病变（PDR）玻璃体手术后视力光感或无光感发生的相关因素。设计回顾性、非对照病例系列。研究对象242例（288眼）因PDR行玻璃体手术的患者。方法回顾2002～2006年因PDR在同仁医院接受玻璃体手术治疗的住院病例,对术后视力为光感/无光感患者的术前糖尿病视网膜病变程度、有无黄斑病变、术后玻璃体再出血、视网膜脱离、新生血管性青光眼和多次手术等因素进行分析,随访1～60个月。主要指标PDR分期、黄斑病变程度、术后并发症。结果根据最后一次随访时视力分组为无光感／光感组（14眼）、有光感组（274眼）（术后视力≥眼前手动）。两组在术前严重黄斑病变、术前PDR6期、术后玻璃体积血、视网膜脱离、新生血管性青光眼、多次手术等方面差异有统计学意义（P值分别为0．048、0．042、0．000、0．048、0．000、0．000）。结论术前严重的黄斑病变、PDR6期、术后玻璃体再出血、术后视网膜脱离、术后继发新生血管性青光眼和多次手术是糖尿病视网膜病变术后视力光感／无光感的相关因素。正确的术中处理、减少术后并发症可降低术后光感／无光感的发生率。（眼科,2009,18：251—253）     

Comparative evaluation of radial optic neurotomy and panretinal photocoagulation in the management of central retinal vein occlusion

PURPOSE: There is currently no treatment proven effective for central retinal vein occlusion (CRVO). Radial optic neurotomy (RON) has recently surfaced as a new treatment for the disorder, however, and we compare here the visual acuity (VA) and arteriovenous transit time (AVTT) following RON and panretinal photocoagulation (PRP). METHODS: We conducted a retrospective, uncontrolled study of 27 patients. Of 27 eyes diagnosed with CRVO, 16 were treated with panretinal photocoagulation (PRP) and 11 with RON. VA and fluorescein angiography were used to monitor the evolution of CRVO, and for follow-up. RESULTS: All patients underwent PRP or RON with no major complications. The difference between pre- and post-operative VA was not statistically significant for either group (p=0.092 on PRP; p=.0081 on RON). The change in AVTT was also not statistically significant for either group (p= 0.024 on PRP; p=0.027 on RON). Ultimately, we found no statistically-significant difference in comparing VA and AVTT for the two groups (p =0.074 on VA; p=0.510 on AVTT). CONCLUSIONS: No evidence supporting the effectiveness of RON could be found in this study, suggesting that surgical decompression by RON may not be effective for treating CRVO. Further studies regarding the efficacy of RON should be made.     

Radial optic neurotomy in central retinal vein occlusion: comparison of outcome in younger vs older patients

PURPOSE: To evaluate the effectiveness of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO) in patients < or =50 years of age (group 1) vs those >50 (group 2). DESIGN: Prospective, interventional, comparative case series. METHODS: The study included 43 consecutive patients with CRVO and preoperative visual acuity (VA) < or =0.70 logarithm of minimal angle of resolution (logMAR). All patients underwent pars plana vitrectomy and RON at the nasal border of the optic disk. VA and optical coherence tomography (OCT) findings were recorded preoperatively and at one, six, and 12 months postoperatively. RESULTS: Systemic hypertension, diabetes, and open-angle glaucoma were statistically significantly more prevalent in group 2 (P < .05). One patient in group 1 had hyperhomocysteinemia, and had another antiphospholipid syndrome. Fifty percent of patients in group 1 gained > or =3 lines of Early Treatment Diabetic Retinopathy Study (ETDRS) vision, vs 33% in group 2. Mean final VA was 0.5 logMAR VA in group 1 vs 0.8 in group 2 (P = .04). Foveal thickness decreased significantly in both groups (P < .001). Ten patients (55.6%) in group 1 and 13 (54.2%) in group 2 developed retinochoroidal collaterals. CONCLUSIONS: Underlying systemic disease does not seem to be an important factor in the pathogenesis of CRVO in younger patients, and thrombophilia was present in only 11% of patients in this age group. RON yielded better functional results in younger patients, although functional improvement remained limited in those with low baseline VA.     

Radial optic neurotomy for ischaemic central vein occlusion

BACKGROUND/AIMS: Ischaemic central retinal vein occlusion (CRVO) accounts for 20-50% of all CRVO. No treatment has been proved to be effective. The efficacy of radial optic neurotomy (RON) was evaluated in eyes with ischaemic CRVO. METHODS: 10 patients with ischaemic CRVO underwent RON. After pars plana vitrectomy, a microvitreoretinal blade was used to incise the scleral ring, cribriform plate, and adjacent sclera at the nasal edge of the optic disc. Best corrected visual acuity (BCVA), intraocular pressure (IOP), fluorescein angiography (FA), multifocal electroretinography (mfERG), and optical coherence tomography (OCT) were measured preoperatively and at 1, 3, and 6 months postoperatively. RESULTS: No visual improvement was noted in the eyes that underwent RON. FA and mfERG showed no increase in retinal perfusion or retinal function postoperatively. Mean macular central thickness changed from 841 (SD 170) mum preoperatively to 162 (SD 34) microm at the sixth postoperative month. One patient had retinal central artery perforation intraoperatively. One patient developed neovascular glaucoma. CONCLUSION: RON in ischaemic CRVO did not improve visual function (by mfERG) or visual acuity although macular thickness did improve. This technique may be associated with potential risks. Randomised studies are needed to corroborate these results.     

Radial optic neurotomy for ischemic central retinal vein occlusion

INTRODUCTION: Occlusion of the central retinal vein (CRVO) is the second most frequent cause for blindness in the course of pathological changes of the vascular system. Vitreous haemorrhages and neovascular glaucoma are known as serious complications. Clinically accepted guidelines for treating CRVO do not exist up to now. In this report our results after radial optic neurotomy (RON) of patients suffering from CRVO associated with visual deterioration are summarised. PATIENTS AND METHOD: 78 patients (mean age 68 year, gender: 41 male, 37 female) with visual acuity of 0.2 or worse were treated with RON. Mean follow-up was 13 months. 35 patients underwent previously haemodilution treatment without success. Visual acuity tests, fluorescein angiographic appearance, OCT and postoperative complications were analysed, in 47 % additionally VEP, ERG and the visual field were evaluated. RON was carried out by conventional pars plana vitrectomy. Neurotomy was performed at the nasal side of the optic disc in all cases. Neither ILM peeling nor gas tamponade was used. Follow-up examinations were carried out after 2 and 4 weeks, after 3 and 6 months and after 3 years. RESULTS: Improvement of morphological parameters could be registered in 95 % of our patients by means of fluorescein angiography or OCT. Visual acuity improved in 81 % and worsened in 10 %. After 6 months patients with non-ischaemic CRVO had a significantly better visual acuity compared to patients with ischaemic CRVO. A retino-choroidal anastomosis could be observed in 38 (48 %) eyes, all these patients experienced visual improvement. The results of VEP and ERG showed partial recovery in all cases. A temporal visual field defect occurred postoperatively in 95 % of our patients. CONCLUSION: Visual acuity of patients suffering from non-ischaemic CRVO with low preoperative visual acuity and short history may improve after RON. Frequent complications were temporal field defects and vitreous haemorrhage. Further randomised studies are necessary to compare these results after RON with other alternative therapeutic procedures, for example, intravitreal injection of VEGF inhibitors.     

Intravitreal tissue plasminogen activator for acute central retinal vein occlusion.

OBJECTIVES: We investigated the efficacy of intravitreal tissue plasminogen activator (tPA) for the treatment of acute central retinal vein occlusion. DESIGN: Twenty-six eyes with central retinal vein occlusion (CRVO, n=23) and hemi-retinal vein occlusion (n=3) with recent onset of visual symptoms (< or = 21 days) were identified and given an intravitreal injection of 65 -110 microg of tPA. RESULTS: Among eyes with CRVO, visual acuity improved to > or = 20/40 in 7 of 23 patients (30.4%) at 6 weeks, and 8 of 23 patients (34.8%) at 6 months. Visual acuity improved or stabilized in 69.6% (16 of 23 patients) at the 6 week visit and persisted with longer follow-up. Four patients developed doubling of the visual angle. No patients developed rhegmatogenous retinal detachment, infection or neovascular glaucoma. One patient developed a small vitreous hemorrhage and 2 developed an increase in the size of pre-existing macular hemorrhage. CONCLUSION: Intravitreal tPA administered early in the course of central retinal vein occlusion did not lead to catastrophic hemorrhagic events. Intravitreal tPA may cause worsening of vision in some patients. While some eyes appear to have benefited from the therapy, no conclusions can be reached because there was not a concurrent control group. A randomized clinical trial is necessary to determine its efficacy. SUMMARY STATEMENT: Intravitreal tPA administered early in the course of central retinal vein occlusion did not lead to catastrophic hemorrhagic events. A randomized clinical trial is necessary to determine its efficacy.     

玻璃体手术和眼内光凝治疗伴玻璃体积血和新生血管膜的视网膜静脉阻塞

目的评估玻璃体手术和眼内光凝治疗伴玻璃体积血、新生血管膜或牵拉性视网膜脱离的视网膜静脉阻塞(retinal vein occlusion,RVO)的疗效。方法复习连续的37例RVO患者经玻璃体手术和眼内光凝治疗的38只眼临床资料。视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)19例20只眼，视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)18例18只眼。结果手术中确认27只眼有新生血管膜，23只眼有牵拉性视网膜脱离。手术后34只眼视力改善，占89.5%，其中22只眼有0.1以上的视力。4只眼视力未变。CRVO组病史较长，手术后视力改善较少。结论玻璃体手术和眼内光凝能改善多数伴有玻璃体积血、新生血管膜和牵拉性视网膜脱离的RVO眼预后。(中华眼底病杂志,1998,14:3-6)     

Histopathologic findings after radial optic neurotomy in central retinal vein occlusion

PURPOSE: Radial optic neurotomy (RON) in central retinal vein occlusion (CRVO) is a novel strategy that is aimed at relief of mechanical pressure on the central retinal vein. We report on histopathologic findings in a human eye 18 weeks after RON. DESIGN: Interventional case report. METHODS: Eighteen weeks after RON for ischemic CRVO, an eye was enucleated because of neovascular glaucoma and examined histologically. RESULTS: Histopathologic evidence demonstrated displaced fragments of Bruch's membrane surrounded by retinal tissue at the nasal side of the papilla. A discrete scar was noted at this site that reached the cribriform plate without involving the adjacent sclera or the retinal vessels. The optic nerve showed advanced atrophy with a small temporal sector of viable nerve fibers. CONCLUSIONS: Histopathologic findings after RON do not provide evidence for the postulated mechanism of action. It appears prudent to further evaluate this technique before its general implementation in the management of CRVO.     

Vitrectomy with complete posterior hyaloid removal for ischemic central retinal vein occlusion: Series of cases

Background  

Central retinal vein occlusion (CRVO) is a common retinal vascular disorder with potentially complications: (1) persistent macular edema and (2) neovascular glaucoma. No safe treatment exists that promotes the return of lost vision. Eyes with CRVO may be predisposed to vitreous degeneration. It has been suggested that if the vitreous remains attached to the macula owing to a firm vitreomacular adhesion, the resultant vitreous traction can cause inflammation with retinal capillary dilation, leakage and subsequent edema6. The roll of vitrectomy in ischemic CRVO surgical procedures has not been evaluated.     

Long-term effects of radial optic neurotomy for central retinal vein occlusion consecutive interventional case series

PURPOSE: To investigate the long-term (minimum 24 months follow-up) clinical results of radial optic neurotomy (RON) following a pars plana vitrectomy (PPV) with internal limiting membrane peeling as treatment for central retinal vein occlusion (CRVO). METHODS: Interventional case series of 14 consecutive patients (14 eyes) with CRVO who were treated with a PPV combined with RON within 1 year of diagnosis. RESULTS: Median baseline visual acuity (VA) was 1.05 logMAR (approximately 0.09 Snellen) in the affected eye. The follow-up period ranged from 24 to 48 months postoperatively, median 30 months. At the 24-month follow-up examination, median VA was 1.005 logMAR in the affected eye-a significant improvement (p = 0.013). Six patients (43%) gained 1 or more lines of VA (mean VA gain = 1.7 lines), while the VA of four patients (29%) improved by 3 or more lines. The eyes with nonischemic CRVO demonstrated a significantly higher improvement in VA (p = 0.0007) than the eyes with ischemic CRVO. CONCLUSION: With RON clinically relevant improvements on a long-term basis seem achievable. Patients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO.     

视网膜中央静脉阻塞并发渗出性视网膜脱离的临床特征

目的探讨视网膜中央静脉阻塞并发渗出性视网膜脱离患者的临床特征.方法回顾性分析视网膜中央静脉阻塞并发渗出性视网膜脱离患者的一般情况及视力、眼压、眼底、荧光素眼底血管造影、眼部超声波等检查资料.结果15例患者中,男性8例,女性7例;年龄18～42岁,平均25岁.5例合并新生血管性青光眼.患者就诊时的视力：光感至0.05.眼底检查显示全视网膜散在出血、视网膜静脉迂曲,黄斑区有明显的水肿和出血,在水肿和脱离区的边缘可见大片渗出.坐位时视网膜脱离为2～5个钟点范围.全部患者均未见视乳头血管吻合支的形成.荧光素眼底血管造影显示大片出血遮蔽荧光或可见后极部毛细血管无灌注区.超声波测量有5只眼平均眼轴长为22.98 mm.结论渗出性视网膜脱离是视网膜中央静脉阻塞的少见、严重并发症.多见于青年患者,易并发新生血管性青光眼,其眼底及荧光素眼底血管造影检查具有特征性.     

玻璃体手术和眼内光凝治疗伴玻璃体积血和新生血管膜的视网膜静脉阻塞

目的评估玻璃体手术和眼内光凝治疗伴玻璃体积血、新生血管膜或牵拉性视网膜脱离的视网膜静脉阻塞（ｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＲＶＯ）的疗效。方法复习连续的３７例ＲＶＯ患者经玻璃体手术和眼内光凝治疗的３８只眼临床资料。视网膜分支静脉阻塞（ｂｒａｎｃｈｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＢＲＶＯ）１９例２０只眼，视网膜中央静脉阻塞（ｃｅｎｔｒａｌｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＣＲＶＯ）１８例１８只眼。结果手术中确认２７只眼有新生血管膜，２３只眼有牵拉性视网膜脱离。手术后３４只眼视力改善，占８９．５％，其中２２只眼有０．１以上的视力。４只眼视力未变。ＣＲＶＯ组病史较长，手术后视力改善较少。结论玻璃体手术和眼内光凝能改善多数伴有玻璃体积血、新生血管膜和牵拉性视网膜脱离的ＲＶＯ眼预后。     

Role of posterior vitreous detachment induced by intravitreal tissue plasminogen activator in macular edema with central retinal vein occlusion

PURPOSE: To evaluate the effects of posterior vitreous detachment (PVD) in macular edema associated with central retinal vein occlusion (CRVO) treated with intravitreal tissue plasminogen activator (tPA). METHODS: The authors conducted a retrospective study of 36 eyes of 36 patients with macular edema by CRVO treated with intravitreal tPA. In 16 of 21 eyes without pretreatment PVD, PVD developed after the treatment. Multiple linear regression analysis was used to evaluate the correlation between logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) changes and several variables. RESULTS: The VA and macular thickness significantly improved after treatment. The pretreatment logMAR VA (R = 0.646; P < 0.0001), PVD development after tPA (R = -0.303; P = 0.025), and age (R = 0.255; P = 0.050) correlated with the logMAR VA at final visit. The greater improvement in logMAR VA was correlated only with PVD development (R = 0.467; P = 0.0041). Macular thickness in the eyes with PVD development was significantly less than without PVD development at the 6-month visit and the end of follow-up. CONCLUSION: The findings suggest that PVD development after intravitreal tPA may partly contribute to the resolution of macular edema and a better VA outcome.     

Problems with attempted chorioretinal venous anastomosis by laser for nonischemic CRVO and BRVO

PURPOSE: To report the complications and long-term results of laser-induced chorioretinal venous anastomosis in vein occlusions. PATIENTS AND METHODS: Eight consecutive eyes, 3 with central retinal vein (CRVO) and 5 with branch retinal vein occlusion (BRVO), were observed for up to 5 years after attempted laser-induced chorioretinal venous anastomosis. Results: Successful chorioretinal venous anastomoses were created in 2 (25%) eyes. Patients had severe complications, including vitreous hemorrhage, choroidal neovascular membrane, choriovitreal neovascularization, rubeosis iridis and neovascular glaucoma. CONCLUSION: The utilization of a chorioretinal venous anastomosis by laser with proposed laser settings as a therapeutic modality should be further analyzed, and a careful long-term follow-up must be done to avoid vision-threatening complications.     

增殖性糖尿病视网膜病变多次手术临床分析

目的：探讨增殖性糖尿病视网膜病变玻璃体切割术后多次手术的原因及处理。方法：回顾性分析3a来因增殖性糖尿病视网膜病变行玻璃体切割术后需要再次手术的患者。结果：患者189眼术后需要再次进行手术的为24例26眼（占总观察眼数13.8%）。分别是：玻璃体再积血3眼,前房积血1眼,视网膜脱离11眼（占总观察眼数5.8%,占再手术眼42.3%,其中3眼合并新生血管性青光眼）,白内障6眼（占总观察眼数3.2%）,单纯硅油取出5眼。189眼中有6眼发生了新生血管性青光眼（3.2%）,6眼均为玻璃体晶状体联合手术或玻璃体切割术后又摘除白内障病例。2次手术19眼,3次或以上手术7眼（其中5眼合并视网膜脱离）。结论：发生视网膜脱离是糖尿病视网膜病变玻璃体切割术后需要多次手术的主要原因;也占据需要3次或以上手术的主要部分。新生血管性青光眼的发生值得重视,出现视网膜脱离时要提高警惕,需要摘除晶状体时必须慎重。     

Radial optic neurotomy with adjunctive intraocular triamcinolone for central retinal vein occlusion: 63 consecutive cases

PURPOSE: Central retinal vein occlusion (CRVO) is a leading cause of permanent retinal vascular blindness. In a previous communication the authors reported the results of radial optic neurotomy (RON) in 117 consecutive patients with severe CRVO. Persistent cystoid macular edema (CME) and macular pigmentation (MP) were observed and correlated with worse macular function. Intraocular triamcinolone (IOK) has been used to treat patients with CME and CRVO. The authors performed RON with simultaneous, adjunctive IOK (RON/IOK) in patients with CRVO to ascertain any anatomic or visual benefit of this combined approach. METHODS: Pars plana vitrectomy and RON were performed on a case-by-case basis on 63 consecutive patients with CRVO and visual acuity of 20/200 or worse. At the end of the case, 4 mg of triamcinolone was injected into the vitreous cavity (RON/IOK). Patients were observed with serial fundus photographs, fluorescein angiography (FA), Snellen visual acuity (VA), intraocular pressures (IOP), and biomicroscopy for anterior segment neovascularization (ANV). Anatomic and visual outcomes were compared to a previous series of 117 patients with severe CRVO undergoing RON alone. RESULTS: Clinical improvement as determined by fundus examination, photography, and FA was noted in 93% of patients following RON/IOK. Snellen VA improved by an average of three lines (range one to seven) in 68% of all patients. Two or more lines were gained in 44% of patients and four or more lines were gained in 20% of patients. ANV developed in 7% of patients following RON/IOK. Persistent CME and MP were noted in 17% and 28% of patients, respectively. These outcomes were similar to patients undergoing RON alone without IOK. Elevated IOP was noted in 25% of patients and one patient developed endophthalmitis following RON/IOK. CONCLUSIONS: Surgical decompression of CRVO via RON/IOK is a technically feasible procedure. Clinical resolution of the CRVO and improved visual function noted in RON/IOK paralleled outcomes following RON alone. RON/IOK was associated with a higher incidence of elevated IOP and endophthalmitis.     

A long-term follow-up of Eales’ disease

Purpose: To provide long-term follow-up information on Eales’ patients. Methods: Eales’ patients, who had been examined at varying periods between the years 1970 and 1991 with a minimum five-year follow-up, were included in the study. Results: A total of 130 patients were followed up for a minimum of five and a maximum of 26.5 years. The retinal lesions found during the first examination included vascular sheathing, disc and/or retinal neovascularization, vitreous hemorrhage, branch retinal vein occlusion, retinitis proliferans, and retinal detachment. Visual acuity improved in 37 (20%) of the 185 treated eyes, was maintained in 79 (43%), and worsened in 69 (37%). The complications were tractional detachment, cataract, rubeosis iridis, neovascular glaucoma, and phthisis bulbi. Conclusion: The most important elements in dealing with Eales’ disease are periodic follow-up, a good and adequate laser treatment, pars plana vitrectomy combined with procedures for nonclearing vitreous hemorrhage, and retinal vasoproliferative changes to stabilize the retinal lesions and maintain functional levels of vision.