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ARTICLES
Year : 1979  |  Volume : 27  |  Issue : 4  |  Page : 95

Results of clinical trials of tuberculin desensitisation in cases of Eale's diseases


Patnye Eye Hospital, "Alankar" Gondal Rd. Rajkot-2, India

Correspondence Address:
H L Patney
Patnye Eye Hospital, "Alankar" Gondal Rd. Rajkot-2
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Patney H L, Patney S. Results of clinical trials of tuberculin desensitisation in cases of Eale's diseases. Indian J Ophthalmol 1979;27:95

How to cite this URL:
Patney H L, Patney S. Results of clinical trials of tuberculin desensitisation in cases of Eale's diseases. Indian J Ophthalmol [serial online] 1979 [cited 2020 Nov 24];27:95. Available from: https://www.ijo.in/text.asp?1979/27/4/95/32586

Among a large number of factors, tuberculo­sis has been described as a cause of Eale's disease, but consensus of opinion of the parti­cipants in the symposium on the subject in the international ophthalmological conference held at New Delhi in 1962, was that the condition was not due to active tuberculosis but to a state of abnormal sensitivity to tubercular proteins. The aim of this was to see the effect of desensi­tisation to tubercular proteins, on the clinical course of the disease.


  Materials and Methods Top


All twenty cases out of our series who had been clinically diagnosed as cases of Eales' disease were found to be hypersensitive to 5Tu/o.lcc of tuberculin p.p.d injected intradermally. The erythema varied from 20 to 90 mm and induration from 15 mm to 44 mm.

The fundus picture varied from a chance discovery of retinal vasculitis with or without one or more peri­pheral haemorrhages to cases of frequent haemorrhages in retina and vitreous (small or large) and neovasculari­sation forming loops and network. Some old standing cases showed blood vessels projecting into the vitreous with or without proliferating fibrous tissue. The oldest patient in our series was a man of 46 years who was also a diabetic and the youngest 20 years of age.

The cases were divided in groups according to the degree of sensitivity to p.p.d.

Method: At first we started using old tuberculin. Injection of p.p.d. were given starting with 0.1 cc (5Tu) intramuscularly and increasing by 0.25cc at the interval of 5 days till l.0cc was reached. Then the same dose was repeated 4 times at 8 days interval. In case of general reaction like malaise with fever, same dose was repeated till no reaction took place. The fever was never high, about 100°.F or so and usually came down with one tab of aspirin. Tuberculin senstivity test was repeated 3 weeks after the last injection and if still found hypersensitive, 1.0 cc injections were repeated at eight days interval. The number of injections (4-6 or 8) de­pended upon the size of the sensitivity reaction. We found that out of 20 cases, 4 required a repetition of four injections and 2 required a repetition of 8 injections.

Results: 16 cases out of 20 i.e. 80% who were followed up for 2-5 years had definite and remarkable result. None of these cases has had any haemorrhage or active periphlebitis for the past 2-5 years. Fundus examination after injection of fluorescein did not show any leakage. Neovascularisation in the retina in cases in which it existed had disappeared leaving behind white lines of obliterated vessels in 4 cases, and in two cases no evidence was left of new formed vessels indicating probably a short duration of disease.


  Discussion and conclusion Top


The authors have treated a large number of cases by photocoagulation and have found that the good effect on haemorrhages was temporary only. Hence they feel that every case of Eales' disease who shows hypersensitivity to tuberculin protien should be desensitised. Only 20 cases have been described as these have been followed up for a period of 2-5 years.

We hope that this paper will stimulate further study of this method of treatment which seems to be curative as it deals with the cause of the disease.




 

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