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4th Edition of

International Ophthalmology Conference

March 23-25, 2026 | Singapore

IOC 2026

Beyond the classic IRVAN an atypical presentation of Eales disease

Speaker at International Ophthalmology Conference 2026 - Isha Acharya
C L Gupta Eye Institute, Moradabad, India
Title : Beyond the classic IRVAN an atypical presentation of Eales disease

Abstract:

Purpose: To report an unusual case demonstrating overlapping features of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) and Eales' disease, highlighting the diagnostic challenges in atypical retinal vasculitis.

Methods: A 31-year-old male presented with sudden-onset blurring of vision in the left eye for 10 days. Detailed ocular examination, multimodal imaging and systemic evaluation were performed.

Results: Best-corrected visual acuity was 20/20 in the right eye and 20/30 in the left. Fundus revealed optic disc edema, partial macular star, and perivenous sheathing. Capillary aneurysmal dilatations were noted superior to disc. OCT showed peripapillary subretinal fluid, and angiography demonstrated aneurysmal vascular dilatations over the disc, late disc staining, peripheral capillary non-perfusion, and non-leaky capillary dilatations without definite neovascularization. Systemic work-up showed positive Mantoux, raised ESR, a normal IGRA, c-ANCA and normal chest CT. The patient was treated with intravenous methylprednisolone followed by oral steroids, resulting in complete resolution of subretinal fluid, though vascular dilatations persisted. The case fulfilled two major IRVAN criteria (neuroretinitis, vasculitis) and one minor criterion (capillary non-perfusion). Early-phase angiography suggested possible optic nerve head aneurysmal changes, potentially meeting the third major criterion. However, Mantoux positivity and occlusive venous periphlebitis supported an atypical presentation of Eales' disease.

Conclusions: This case represents a rare IRVAN-like variant of Eales' disease—not previously reported. It underscores overlapping phenotypes in retinal vasculitis and emphasizes the need for flexible diagnostic interpretation, multimodal imaging, and long-term follow-up to guide individualized management.

Biography:

Isha Acharya received both her MBBS and MS(Ophthalmology) degrees from Delhi's reputed UCMS & GTB Hospital. She completed her fellowship training in Vitreoretinal surgery, ROP, and Uvea from the renowned institute Narayana Nethralaya, Bangalore. She has a strong passion for academics, as demonstrated by her multitude of International and National indexed publications and presentations. She also secured the Best Poster discussion Award in the Uvea/Retina category at the 2023 Asia Pacific Academy of Ophthalmology (APAO) conference, showcasing her expertise at an International forum. Adding to her accolades, the All India Ophthalmological Society(AIOS) honored her with the prestigious International Hero Award in 2023 for her outstanding contributions.

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