Step 1: The common thread the question is testing is peripheral retinal ischaemia leading to new vessel fronds shaped like a sea-fan or parachute. Identify which listed diseases produce that ischaemic proliferative state.
Step 2: Sickle cell anemia is the textbook owner of the sea-fan - peripheral arteriolar occlusion from sickling creates non-perfused retina and fan-like neovascular tufts.
Step 3: Eales disease, an obliterative perivasculitis affecting the peripheral veins of young men, equally leads to capillary dropout, neovascular tufts and vitreous bleeds.
Step 4: Proliferative diabetic retinopathy completes the trio, with extensive capillary non-perfusion generating fan-shaped neovascularization. Because each of the three is a proliferative ischaemic retinopathy showing these fronds, no single option can be excluded.
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