Glaucoma, OCT showing deterioration since starting Pred for PMR

[Sillydogsmum]

I am on 17mgs Pred for PMR for 6 weeks. I have had glaucoma for 8yrs . At my opthalmology FU today the, OCT showed marked deterioration in one eye since March. The GCC Analysis has gone all red, when it was mildly yellow before. Has anyone else noted the same when they went on steroids? I am off for an MRI . The IOP is 20 which is a bit higher than one would like but opthalmo thinks doesn't explain why GCC should have changed so much. Apologies for the techno-speak but folks with OCT follow up will know what I am on about. CRP down to 1.3 so not likely to be anything arteritic.

[DorsetLady PMRGCAuk volunteer]

Pred can increase the pressure in the eyes… it’s listed as a side effect, so if yours were already raised before you started the meds that may be why. Would have thought the ophthalmologist would have been aware of that, but maybe not.

Are you on medication for glaucoma- if so it may need increasing temporarily - the pressures should reduce as your Pred doses go down.

[Sillydogsmum in reply to DorsetLady]

Since starting the pred pressure is same in one eye 15 and gone up to 20 from 17 in other( the one with the oct change) She was concerned that the change in oct analysis seemed disproportionate to the rise in pressure. I am on Latanoprost. Due to see her again after MRI in early October. I have already been on timolol and dorzolamide. I also have multiple vitreous opacities, cataract implants, high myopia and previous vitreous detachments so reckon I might be in the 'complicated category ' I also have another opthalmo for higher level care, so I hope she will agree to me going to see him again after mri.

[DorsetLady PMRGCAuk volunteer in reply to Sillydogsmum]

Definitely in the “complicated category’ - so yes you do need to consult the expert… my pressures did rise initially but on silly doses for GCA at all it’s complications, but fortunately not enough to require medication, just monitoring and they did reduce within a few months…

Fingers crossed for you… you have enough eye issues as it is… 🌸

[Sillydogsmum in reply to DorsetLady]

Thank-you, but mustn't grumble. 🤕At least not today ! 😎

[Viveka]

Had glaucoma in R eye couple of years before GCA. On pred 2 1/2 years now - luckily hasn't deteriorated, although pressures sometimes high and was on 3 month check ups for a while but now back to 6 months. Fingers crossed. Hope all goes well for you. Is lazer a possibility?

[Sillydogsmum]

Thanks, certainly i think I'm on the point of mentioning the possibility. I definitely want the pressures sub 15 if poss.

[Booklover57]

hi, not sure I can add usefully, but I had slightly raised pressures for some years before being diagnosed (wrongly) with GCA last June 2022. I was on 40 mg pred for around three months before beginning a taper down, and finally stopped taking pred in February this year. In October I fortunately visited an optician who found my pressures were 42 and 34. I was prescribed Ganfort (bimatoprost/timolol) drops and my pressures reduced to 17 and 14. The doctor at my most recent visit to Ophthalmology said these were ok but not good enough to stop the drops, despite almost seven months without steroids. I too have posterior vitreous detachment. All good wishes.

[Sillydogsmum in reply to Booklover57]

Thanks for ypur reply, I havent tried bitamoprost/timolo combo, just the timolol/dorzolomide one. Do you get followed up with OCT in the UK. Funny bit of white kit that looks like ET with one eye

[Booklover57 in reply to Sillydogsmum]

I’m not sure to be honest! I think so - I certainly have a scan at my six monthly check up at Moorfields. I know Specsavers offer them at a small extra cost too.

[Purple-Owl]

I have cataracts as well as high pressure in both eyes My eye surgeon has attributed this possibly to long term steroid medication. I have been on pred for 6 years. He says he will perform a drainage procedure to relieve the pressure along with the cataract op i am booked for later this month.

[Koalajane in reply to Purple-Owl]

Good luck with the ops

[Ruthie64]

I had cataracts removed. First one removed Dec last year and has healed fine but was only on low dose of pred. Second one in Feb has not healed, inflammation at the back of the eye apparently. They said the preds were slowing the healing. I was on a high dose of preds due to colitis. Been up and down on the preds throughout this year but now down to 9mg. My eye is no better. Been referred to opthalmology but a 32 week waiting list 😭 I'm just praying as I get lower on the preds my eye will improve. 🙏🏻

[Sillydogsmum in reply to Ruthie64]

Presumably its your optician who has referred you? Might be worth asking them for a copy of the letter so you know exactly what is the matter? If it is thought to be post op problem you shouldn't have to wait as if it was à new referral? On the whole cataract issues are'front of eye'. Other thought is your blood sugar OK recently?

[Ruthie64 in reply to Sillydogsmum]

The problem is inflammation at the back of the eye after surgery caused by the steroids apparently. It's not getting any better after 7 months but they think it may be the preds slowing the healing. My blood sugars are fine. It was the surgeon who did my cataract surgery who wrote to my GP and asked them to refer me opthalmology dept at my local hospital.

[Sillydogsmum in reply to Ruthie64]

Are you caught up in the private/ nhs interface?

[Ruthie64 in reply to Sillydogsmum]

All done through nhs

[Sillydogsmum]

?worth a call to opthalmology outpatients seccy at hospital to jolly it up. Or get your optician to take a look, they might see fit to expedite things if they are worried and also may better explain of what might be wrong so you know where you with it all.Best of luck.