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Vitreous liquefaction #282378
01/12/19 10:31 AM
01/12/19 10:31 AM
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achala Offline OP
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achala  Offline OP
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After new onset of floaters in both eyes and visit to the clinic (I also have some strange tremor/ripples like sensation in the eye liquid), and they said no inflammation but onset of PVD (posterior vitreous detachment).
Trying to to find out a little bit more about the new enemy I found the below article I thought would be interesting to share.

http://retinatoday.com/2016/06/vitreous-the-next-frontier/

not sure how the aggressive treatment with corticosteroids impacts Vitreous liquefaction at such a young age of 38, but inevitably i feel I overdosed....

going to buy high doses of vitamin C

Last edited by achala; 01/12/19 10:57 AM.

diagnosed with AS April 2018, starting with cervical pain/stiffness; Aug 2018 enthesitis/bursitis left Achilles
diagnosed with iridociclitis Nov 2017 (4 flares so far) - bilterally DES,PVD
Eosinophilic Gastritis
Signs of inflammations/erosions on MRI`s for axial and Achilles/calcaneus + bursitis
Naproxen (occasionally), Sulfasalazine 3000 mg per day
Supplements: vit A/C/D, reishi mushrooms, fish oil/probiotic/ Mediterranean NSD
plenty of swimming
Re: Vitreous liquefaction [Re: achala] #282381
01/12/19 04:32 PM
01/12/19 04:32 PM
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Posts: 124
Iowa City, IA USA
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DadCue Offline
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I'm sorry that you are having problems with your eyes. I don't have any recommendations.

I had recurrent uveitis (mostly left eye) and the symptoms you describe are very familiar to me. I would also include "light flashes" which would startle me enough to cause me to break out running. Fortunately, the light flashes didn't ever happen while driving but I worried about what would happen if it did.

The first few episodes of uveitis were called "aggressive" and losing my vision seemed more likely than not. One time, I was on a flight to Germany with Romania as my destination. It was very troubling to say the least. I was able to get some prednisone in Germany and was comfortable enough to continue on to Romania. That was 25 years ago.

I remember many conversations with my ophthalmologist as each uveitis spiraled out of control. Bursts of high dose prednisone became a routine. I was in my late 30's and early 40's during this time. I was devastated when advanced cataracts were diagnosed. I specifically asked if the cataracts were caused by prednisone. The answer was, "No, more likely caused by uveitis". I'm sure that prednisone didn't help the problem of early onset cataracts, however, I am convinced it preserved my vision.

I stopped having uveitis 10 years ago. That coincides exactly with the day when I started taking low dose prednisone daily. Perhaps a coincidence ... I don't know. Sulfasalazine and other NSAIDs was tried prior to this and they were helpful but the GI side effects prevented me from taking them.. My general belief is that all medications are poison. I hope that you find a poison that works for you. I think there is a TNF inhibitor that works for both uveitis and AS but I'm not sure which one.



Re: Vitreous liquefaction [Re: DadCue] #282388
01/12/19 11:27 PM
01/12/19 11:27 PM
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seymour Offline
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Originally Posted by DadCue
I I think there is a TNF inhibitor that works for both uveitis and AS but I'm not sure which one.


I think all of them except etanercept (Enbrel).

Re: Vitreous liquefaction [Re: achala] #282394
01/13/19 12:42 PM
01/13/19 12:42 PM
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Whidbey Island WA
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WhiteCell Offline
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Remicade is the TNF which has the best response to uveitis.

At 24 I had pain in the right eye. Found through family an MD near me and the journey began. Hundreds of MD visits. Pred forte hourly many bouts, tapering, one flare requiring needle injection of steroids. only the right eye. Once Remicade started 2001 uveitis flares stopped however eye drops at 4xday always. This led to formation of cataract (it's the drops) with increasing ocular pressure which required a lens replacement and trabeculectomy which worked until it didn't 3 years later required corneal transplant and 9 years later placement of an Ahmed shunt and 2nd corneal transplant. now on 1 drops durezol and 1 drop timolol. vision is 80% some days worse others.

Good news, there are solutions and really talented micro surgeons and dedicated ophthalmologists who care.
Bad news. It's been a marathon sometimes terrifying sometimes humbling.

Takeaway... We are stronger than we think we are.

Last edited by WhiteCell; 01/13/19 12:44 PM.

Starting at 18 yrs old > Reiter's Syndrome. Diagnosed 2001 Ank Spon.
Started Remicade 2002 - 5mg/kg every 7 weeks.

Right Eye Glaucoma- Trabeculectomy/lens replacement 2006.
Right eye DSEK Cornea Transplant 2009.
Right eye Ahmed Shunt 2016.
Right eye DSEK Cornea Transplant 2016.
Supra Ventricular Tachycardia. 2004. Cured by RF ablation 2008.

ICU RN - Seattle, WA

~Grasp The Challenge and Succeed~
Re: Vitreous liquefaction [Re: WhiteCell] #282396
01/13/19 04:48 PM
01/13/19 04:48 PM
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DadCue Offline
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Originally Posted by WhiteCell
Remicade is the TNF which has the best response to uveitis.

At 24 I had pain in the right eye. Found through family an MD near me and the journey began. Hundreds of MD visits. Pred forte hourly many bouts, tapering, one flare requiring needle injection of steroids. only the right eye. Once Remicade started 2001 uveitis flares stopped however eye drops at 4xday always. This led to formation of cataract (it's the drops) with increasing ocular pressure which required a lens repacement


My journey was similar and yes, very humbling. I have no doubts that Remicade works well. I can relate to hundreds of MD visits probably within the first 3-4 bouts of uveitis. The drops were quickly discarded simply because I couldn't put them in fast enough. Rapid treatment wasn't an issue because I could usually detect it was happening again was seen within hours. Funny story --- I once was working and maybe within one hour I noticed things were getting very foggy. I asked a coworker about the the fog and her response was "No, there's no fog but your eye is beet red". Usually, I felt some pain first so this particular time was an exception. The rapid onset and rapid progression was usually the case. Usually within a couple days, my vision deteriorated to the extent that I unable to see my hand even if I held it inches away. I was always grateful for having two eyes because always the uveitis would only be a problem in one eye. I did have a few times where my left eye would flare and be treated only to have the right eye develop a mild flare. I felt lucky in that regard! I also thought it was strange how only one eye at a time would flare.

It has been a marathon and sometimes terrifying. It was always reassuring when a white light was shined directly in my eye and I was asked what color I saw. I would always see white even if I couldn't see anything else. My doctor would say as long I could still see white and not black then I wasn't blind.

Perhaps, I became too reliant on prednisone. I quickly learned how effective it was for a wide variety of mystery pain in addition to uveitis. In fact, uveitis eventually was not that big of an issue as long as I started taking prednisone quickly. It became so routine that eventually a recurrence of uveitis involved two, sometimes three visits to the opthalmologist. The agreement was as long as I called in and be seen in order to verify that it was uveitis and not something else, the prednisone dosing and taper was up to me. If I felt it was getting worse I was instructed to call and be seen again, otherwise, follow-up was 1 month. There were times when I was still self tapering after one month but the uveitis was never worse. In that case, the follow-up was an additional month but by then the uveitis was resolved and I was off prednisone.



Re: Vitreous liquefaction [Re: achala] #282397
01/13/19 06:04 PM
01/13/19 06:04 PM
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achala Offline OP
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Thank you for sharing.
The last bout of iritis left some iris pigmentations on my lens since was so bad while I was on holiday and at that time I didn’t have possibly to go to hospital that iris got glued to the Pupil and couldnt open anymore.
Now on sulfasalazine since 4 months seems no uveitis because I check each month routinely with ophthalmologist.
But do you have floters? They are very annoying in my case.
And the recent pvd diagnosing makes me sick to the stomach again. I thought i could have had some peace.


diagnosed with AS April 2018, starting with cervical pain/stiffness; Aug 2018 enthesitis/bursitis left Achilles
diagnosed with iridociclitis Nov 2017 (4 flares so far) - bilterally DES,PVD
Eosinophilic Gastritis
Signs of inflammations/erosions on MRI`s for axial and Achilles/calcaneus + bursitis
Naproxen (occasionally), Sulfasalazine 3000 mg per day
Supplements: vit A/C/D, reishi mushrooms, fish oil/probiotic/ Mediterranean NSD
plenty of swimming
Re: Vitreous liquefaction [Re: achala] #282398
01/13/19 08:48 PM
01/13/19 08:48 PM
Joined: May 2018
Posts: 124
Iowa City, IA USA
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DadCue Offline
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Originally Posted by achala
The last bout of iritis left some iris pigmentations on my lens since was so bad while I was on holiday and at that time I didn’t have possibly to go to hospital that iris got glued to the Pupil and couldnt open anymore.
Now on sulfasalazine since 4 months seems no uveitis because I check each month routinely with ophthalmologist.
But do you have floters? They are very annoying in my case.
And the recent pvd diagnosing makes me sick to the stomach again. I thought i could have had some peace.


Yes, to everything---I hope the iris and pupil could be unglued!!! Early on, that happened once and I sat in the chair for hours getting dilating drops every 15 minutes until it broke free. They were discussing other options but fortunately nothing else was needed. Keeping your eye dilated while the uveitis was active was recommended but made it more uncomfortable. Early intervention and overnight dilation worked well to to prevent this.

The sulfasalazine and other NSAIDs were helpful but only extended the time between flares and didn't prevent them. in general, Remicade or some other TNF inhibitor may be a better option. I was told frequently it was possible the uveitis would stop for some unknown reason so there is that to hope for.



Re: Vitreous liquefaction [Re: achala] #282399
01/13/19 08:54 PM
01/13/19 08:54 PM
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WhiteCell Offline
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The key is to be seen right away and I carry my eye drops in case I can't see an ophthalmologist right away. While that is not a great idea it does prevent severe flares. I also had floaters and occasionally still do.

There are laser procedures which can quickly reconnect the vitreous. I had one last year when I noticed bright ring like flashes in my left eye. It took the doctor an extensive time to look at my eye. The procedure went quickly and left some floaters but those went away after a couple of weeks. Nothing since then.


Starting at 18 yrs old > Reiter's Syndrome. Diagnosed 2001 Ank Spon.
Started Remicade 2002 - 5mg/kg every 7 weeks.

Right Eye Glaucoma- Trabeculectomy/lens replacement 2006.
Right eye DSEK Cornea Transplant 2009.
Right eye Ahmed Shunt 2016.
Right eye DSEK Cornea Transplant 2016.
Supra Ventricular Tachycardia. 2004. Cured by RF ablation 2008.

ICU RN - Seattle, WA

~Grasp The Challenge and Succeed~
Re: Vitreous liquefaction [Re: WhiteCell] #282400
01/13/19 09:17 PM
01/13/19 09:17 PM
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achala Offline OP
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Originally Posted by WhiteCell

There are laser procedures which can quickly reconnect the vitreous.

Would you remember how the procedure is called ?


diagnosed with AS April 2018, starting with cervical pain/stiffness; Aug 2018 enthesitis/bursitis left Achilles
diagnosed with iridociclitis Nov 2017 (4 flares so far) - bilterally DES,PVD
Eosinophilic Gastritis
Signs of inflammations/erosions on MRI`s for axial and Achilles/calcaneus + bursitis
Naproxen (occasionally), Sulfasalazine 3000 mg per day
Supplements: vit A/C/D, reishi mushrooms, fish oil/probiotic/ Mediterranean NSD
plenty of swimming
Re: Vitreous liquefaction [Re: achala] #282402
01/14/19 12:31 AM
01/14/19 12:31 AM
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WhiteCell Offline
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I don't I'm sorry. She did the procedure in her office took about 30 minutes.


Starting at 18 yrs old > Reiter's Syndrome. Diagnosed 2001 Ank Spon.
Started Remicade 2002 - 5mg/kg every 7 weeks.

Right Eye Glaucoma- Trabeculectomy/lens replacement 2006.
Right eye DSEK Cornea Transplant 2009.
Right eye Ahmed Shunt 2016.
Right eye DSEK Cornea Transplant 2016.
Supra Ventricular Tachycardia. 2004. Cured by RF ablation 2008.

ICU RN - Seattle, WA

~Grasp The Challenge and Succeed~
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