Vasculitis of the eye

[Udupik]

I have vasculitis of the eye and have steroid implants in the eye. Now the ozurdex implant is wearing away and the oedema is back in the eye. The immunosuppressant ( metothexrate) which is I was using for 16 weeks has not managed to stop the oedema. Till ozurdex was present, oedema was at bay. Now that it has gone , the immunosuppressant was supposed to do its work and it hasn't. Any ideas on what is the way ahead ?

[Grizzly-bear]

Are you on any maintenance dose of Prednisolone? I used steroid eye drops initial and am also on low dose Prednisolone and six monthly rituximab. Mine hasn’t flared again in my eye (though I get flares elsewhere - usually nose and knees).

[Udupik in reply to Grizzly-bear]

Thanks for your response. Do you have vasculitis of eye too ? Has riruximab helped..? yes I'm on a small dose of predisolsone.

[Grizzly-bear in reply to Udupik]

The eye is one of the places I have vasculitis. Mine was widespread at the time of diagnosis (eye, ears, nose, kidneys, esophagus, stomach, joints).

Because I was in kidney failure when diagnosed I was hit with a lot of treatment so hard to say what worked at getting it under control exactly but mine cleared up in my eye quite quickly with:

- Methylprednisolone via IV for 3 days

- Cyclophosphamide (1 round)

- Rituximab (two doses two weeks apart then every 6 months)

- steroid eye drops

- Maintenance dose of Prednisolone

So I can’t be sure exactly what got it under control in the first instant, but maintenance rituximab and prednisolone seems to have kept it at bay for over a year now. Haven’t had steroid eye drops in over a year.

[Udupik]

Ok. Good luck and thanks

[Dingledaw]

Don't know how long you've had this, but if it's recent, as in started in the last 3 years, then maybe Paxlovid after the current study is done? Eyes are an immune privileged site.

[Udupik in reply to Dingledaw]

Yes..in past 1.5 years. Is there a link to the study that you are mentioning?

There is some argument that the uveitis could have been triggered by covid or the vaccine.

[Dingledaw]

I'm aware of the study being done but it's only just started and due to complete in a year's time. See link below. There's no mention of the eyes, but it may turn out there's viral persistence which could explain any of the sequelae My eyes keep flaring up: conjunctival no uveitis. That happens and always in conjunction with increased SOB. The eye hospital couldn't name my inflammation and said they'd not seen it before.clinicaltrials.gov/ct2/show...