Abstract：
Background: Eales disease is a clinical syndrome affecting the mid-peripheral retina with an idiopathic occlusive vasculitis and possible subsequent retinal neovascularization. The disease can develop into visually threatening complications. Case Presentation: We report the case of a 40-year-old Caucasian male with a history of cocaine abuse who presented with blurred vision in the left eye (LE). Fundus examination showed vitreous hemorrhages, peripheral sheathing of venous blood vessels, areas of retinal neovascularization in the LE, and peripheral occlusive phlebitis in the right eye. The full serologic panel was negative except for the heterozygous mutation of factor V Leiden. Clinical and biochemical parameters suggested a diagnosis of Eales disease. Therapy with dexamethasone, 1 mg per kg per day, tapered down slowly over 4 months, and peripheral laser photocoagulation allowed a regression of clinical signs and symptoms. Conclusion: This case shows an uncommon presentation of Eales disease associated with cocaine abuse. Both cocaine abuse and a thrombophilic pattern, as cofactors, might have sensitized the retinal microcirculation on the pathogenetic route to this retinal pathology. Furthermore, in view of this hypothesis, a thorough ocular and general medical history investigating drug abuse and coagulation disorders is recommended for ophthalmologists in such cases.
摘要：
背景：Eales病是一种影响中周边视网膜的临床综合征，伴有特发性闭塞性血管炎和随后可能的视网膜新生血管形成。该疾病可发展成视觉威胁的并发症。病例介绍：我们报告了一名40岁的白人男性，有可卡因滥用史，左眼视力模糊（LE）。眼底检查显示玻璃体出血,静脉血管的外周鞘，LE的视网膜新生血管区域，和右眼周围闭塞性静脉炎。除了因子VLeiden的杂合突变外，整个血清学面板均为阴性。临床和生化参数提示诊断为Eales病。用地塞米松治疗，每天每公斤1毫克，在4个月内慢慢减少，和外周激光光凝使临床体征和症状消退。结论：此病例显示与可卡因滥用相关的Eales病的罕见表现。可卡因滥用和血栓形成，作为辅因子，可能在这种视网膜病变的发病途径上使视网膜微循环敏感。此外，鉴于这一假设，在这种情况下，建议眼科医生进行全面的眼科和一般病史，以调查药物滥用和凝血障碍。
