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Dear Doctor, I Am Mrs. Neha Haria, 31 Years Old.
Dear Doctor,
I am Mrs. Neha Haria, 31 years old. I was first diagnosed with serpeginious choroiditis in my left eye in 2012. I was initially treated with wysolone (started with 60mg per day and tempered 10mg every 10days. ) I was 90% cured in about 6 months and the disease came up again in the same eye, in about 6 months from the date of curing. In March 2013 i consulted a Retina Specialist with complaint of left eye floaters increased since 1 year and blur vision. I had undergone both eyes LASIK surgery in 2007 & I was was putting Gatiquen eyedrops 4 times in left eye.
in 2013 on examination, my right eye vision was 6/6, N6 and left eye 6/12, N10, pinhole improving to 6/6P. Slit lamp examination was normal, fundus examination showed active choroiditis patch in macula and disseminated choroiditis patches in general fundus. I was then advised to start with Tab Wysolone 40 mg. Her basic blood investigations, CT scan chest was normal. This was in March 2013.
On follow up on 1 April 2013, my left eye vision was 6/9P,N8 with pinhole improving to 6/6P, fundus also showed choroiditis patch healing. The oral steroid dose was tapered every 10 days.
On 11 May 2013, there was drop in left eye vision to 6/60,<N36, oral steroids was 15 mg per day.FFA was done it showed Window defect in left eye with some staining of macula with no Fluid on OCT. The oral steroids were again increased to 60 mg for 10 days. Vision drop could have been because of scarring of macula.
On 20 May 2013 my left eye vision was 6/36,N18 with healing choroiditis patch on fundus examination. Oral steroid were tapered every 5 days. On a follow up after 1 week on 28 May 2013, left eye vision was 6/18P, N10 in left eye. I was on Oral steroids 5 mg1-0, fundus showed healing choroiditis patches. As the condition was improving, I was asked to taper the steroids.
I had also taken methyl prednisolone (Solu-Medrol 1GM Injection for three days in May) as the vision started deiminishing and was on 20mg wysolone .
In June 2013, I was on Tablet Wysolone 40 mg per day, her left eye vision was 6/9,N6. Steroids were tapered down every 2 weeks.
In September 2013, my left eye showed defective vision since 15 days, left eye vision was 6/24P,N36P, I was on Tablet Wysolone 5 mg 1-0. Fundus examination showed diffuse active choroiditis, vitreous floaters, healing choroiditis patches, parsplana exudation with snow balls. It was remarked that left eye had panvenous choroiditis parsplana banking and active diffuse choroiditis.
There is no history of tuberculosis or any other ill health. I am only a little over weight mostly sue to the side effects of wysolne that i consumed for over 2 years and the effect of the injection.
I had then seen Dr.JB Biswas in Shankar Netralay in Septembe 2013 who also did polymerase chain reaction of aqueous aspirate for MTB fw mtb from left eye. This is real time polymerase chain reaction or mycobacterium TB and it was negative. Hence I was started on 40mg wysolone again. This went on for a few months till Dec 2013. I stopped all my medicines in 2014 as the left eye vision had only reduced and doctors mentioned this was becasue of scaring and that it was irreversible. I started on homeopathy medicines for a year but there was no use. I have barely 20percent cloudy & wavy vision in my left eye.
All this while my right eye vision was perfect. Unfortunately in June 2015, i started seeing floaters in the right eye. On test and showing the doctor I was informed that he sees active choroiditis in right eye. I was asked to get basic lab test & I started on oral wysolone starting with 40 mg per day. Left eye has 6/60 vision only. Right eye is 6/6N6 .
On examination, my chest X ray showed some congestion in my lungs, my HRCT further mentioned mile central cylindrical bronchiectasis and sub centimeter sized pre-tracheal lympnodes. My blood sugar was normal and ESR in blood report was 45. My mantoux test showed a 25mm erythema & 25mm Induration.
On 20th July my retina specialist stated that the choroiditis in the right eye is increasing and he says "feel juxtafoveal choroiditis, should increase steroids o 500mg iv methylprednisolone and start 60mg wysolone per day".
I have barely any vision in left eye and I m loosing vision in my right eye.. i have no history of any such eye problem whatsoever except that i was myopic. I have no history of tuberculosis..
Can you please advice your best.
I have stated every detail of my history and problem.
Much appreciated.
Regards,
Neha (India).
I am Mrs. Neha Haria, 31 years old. I was first diagnosed with serpeginious choroiditis in my left eye in 2012. I was initially treated with wysolone (started with 60mg per day and tempered 10mg every 10days. ) I was 90% cured in about 6 months and the disease came up again in the same eye, in about 6 months from the date of curing. In March 2013 i consulted a Retina Specialist with complaint of left eye floaters increased since 1 year and blur vision. I had undergone both eyes LASIK surgery in 2007 & I was was putting Gatiquen eyedrops 4 times in left eye.
in 2013 on examination, my right eye vision was 6/6, N6 and left eye 6/12, N10, pinhole improving to 6/6P. Slit lamp examination was normal, fundus examination showed active choroiditis patch in macula and disseminated choroiditis patches in general fundus. I was then advised to start with Tab Wysolone 40 mg. Her basic blood investigations, CT scan chest was normal. This was in March 2013.
On follow up on 1 April 2013, my left eye vision was 6/9P,N8 with pinhole improving to 6/6P, fundus also showed choroiditis patch healing. The oral steroid dose was tapered every 10 days.
On 11 May 2013, there was drop in left eye vision to 6/60,<N36, oral steroids was 15 mg per day.FFA was done it showed Window defect in left eye with some staining of macula with no Fluid on OCT. The oral steroids were again increased to 60 mg for 10 days. Vision drop could have been because of scarring of macula.
On 20 May 2013 my left eye vision was 6/36,N18 with healing choroiditis patch on fundus examination. Oral steroid were tapered every 5 days. On a follow up after 1 week on 28 May 2013, left eye vision was 6/18P, N10 in left eye. I was on Oral steroids 5 mg1-0, fundus showed healing choroiditis patches. As the condition was improving, I was asked to taper the steroids.
I had also taken methyl prednisolone (Solu-Medrol 1GM Injection for three days in May) as the vision started deiminishing and was on 20mg wysolone .
In June 2013, I was on Tablet Wysolone 40 mg per day, her left eye vision was 6/9,N6. Steroids were tapered down every 2 weeks.
In September 2013, my left eye showed defective vision since 15 days, left eye vision was 6/24P,N36P, I was on Tablet Wysolone 5 mg 1-0. Fundus examination showed diffuse active choroiditis, vitreous floaters, healing choroiditis patches, parsplana exudation with snow balls. It was remarked that left eye had panvenous choroiditis parsplana banking and active diffuse choroiditis.
There is no history of tuberculosis or any other ill health. I am only a little over weight mostly sue to the side effects of wysolne that i consumed for over 2 years and the effect of the injection.
I had then seen Dr.JB Biswas in Shankar Netralay in Septembe 2013 who also did polymerase chain reaction of aqueous aspirate for MTB fw mtb from left eye. This is real time polymerase chain reaction or mycobacterium TB and it was negative. Hence I was started on 40mg wysolone again. This went on for a few months till Dec 2013. I stopped all my medicines in 2014 as the left eye vision had only reduced and doctors mentioned this was becasue of scaring and that it was irreversible. I started on homeopathy medicines for a year but there was no use. I have barely 20percent cloudy & wavy vision in my left eye.
All this while my right eye vision was perfect. Unfortunately in June 2015, i started seeing floaters in the right eye. On test and showing the doctor I was informed that he sees active choroiditis in right eye. I was asked to get basic lab test & I started on oral wysolone starting with 40 mg per day. Left eye has 6/60 vision only. Right eye is 6/6N6 .
On examination, my chest X ray showed some congestion in my lungs, my HRCT further mentioned mile central cylindrical bronchiectasis and sub centimeter sized pre-tracheal lympnodes. My blood sugar was normal and ESR in blood report was 45. My mantoux test showed a 25mm erythema & 25mm Induration.
On 20th July my retina specialist stated that the choroiditis in the right eye is increasing and he says "feel juxtafoveal choroiditis, should increase steroids o 500mg iv methylprednisolone and start 60mg wysolone per day".
I have barely any vision in left eye and I m loosing vision in my right eye.. i have no history of any such eye problem whatsoever except that i was myopic. I have no history of tuberculosis..
Can you please advice your best.
I have stated every detail of my history and problem.
Much appreciated.
Regards,
Neha (India).
Sat, 25 Jul 2015
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