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difficult and complicated cases for help! Right scleritis recurrent several times
Below is one of the medical record of a patient, seek help from ophthalmologist,to see if there is any improvement for the treatment regimen.
Thank you very much!!!
Admission condition: "Found that elevated blood sugar for more than five years, right eye pain for three months". Physical examination on admission showed the following: general condition, VOD:0.5 (correction). Fundus examination of optic nerve papilla edema, conjunctival hyperemia edema slightly. Fasting blood glucose: 8MMOL/L, BP:140/90MMHG. CT showed marked thickening of the eye ring.
Admission diagnosis: right scleritis, hypertension, diabetes mellitus, optic nerve papilla edema.
Hospitalization: Accomplished relevant examination after admission. IgE 103.11IU/ml. Urea nitrogen 8.1mmol/L. uric acid 356umol/L. Triglyceride 2.40mmol/L. Total cholesterol 5.29mmol/L, antinuclear antibody, RF ASO, showed no significant abnormality. HLA-B27 positive. Fasting blood glucose 11.4mmol/L. To continue treatment through outpatient by glucocorticoid, decreasing blood glucose, decreasing hypertension. Emerge atrial fibrillation on 4.28, get cardioversion after consultation from Department of Cardiology. The patient was transferred to our department on 5.13. We gave him whole body and the right local specification eye hormone treatment, meanwhile, giving the intraocular pressure lowering drug to treat corticosteroid induced ocular hypertension. During the reducing corticosteroid process, scleritis recurrent several times and intraocular pressure has not been smoothly controlled. After consultation from Zhongshan Medical University eye specialist on 8.31, we decided to add the use of cyclosporin A to control the disease started on 9.15. At the same time, gradually reduced local and systemic hormones combined with cardiovascular, endocrine, digestive, renal medicine treatments respond to corresponding complications.
Discharge: Right eye with blurry vision field, no obvious pain, tenderness. Physical examination: stable vital signs, VOD:1.0 (correction), VOS:1.5 (correction). Binocular conjunctival edema obviously, no obvious hyperemia. B ultrasound showed thickness of temporal side wall of right eye ball 1.5MM, left temporal side eye ball wall 1.2MM, right eye fundus examination of optic disc shows clear boundary, the superior temporal branch of artery sclerosis and shows copper wire reflection
Discharge medication: methylprednisolone and cyclosporine A treatment:
(1)cyclosporine A 50MG BID PO until 3.15
(2)methylprednisolone tablets 11.30 2.5# QD, 12.15 2# QD, 12.30 1.5# QD,
1.14 1# QD, 2.13 0.5# QD, 3.15 drug withdrawal
Thank you very much!!!
Admission condition: "Found that elevated blood sugar for more than five years, right eye pain for three months". Physical examination on admission showed the following: general condition, VOD:0.5 (correction). Fundus examination of optic nerve papilla edema, conjunctival hyperemia edema slightly. Fasting blood glucose: 8MMOL/L, BP:140/90MMHG. CT showed marked thickening of the eye ring.
Admission diagnosis: right scleritis, hypertension, diabetes mellitus, optic nerve papilla edema.
Hospitalization: Accomplished relevant examination after admission. IgE 103.11IU/ml. Urea nitrogen 8.1mmol/L. uric acid 356umol/L. Triglyceride 2.40mmol/L. Total cholesterol 5.29mmol/L, antinuclear antibody, RF ASO, showed no significant abnormality. HLA-B27 positive. Fasting blood glucose 11.4mmol/L. To continue treatment through outpatient by glucocorticoid, decreasing blood glucose, decreasing hypertension. Emerge atrial fibrillation on 4.28, get cardioversion after consultation from Department of Cardiology. The patient was transferred to our department on 5.13. We gave him whole body and the right local specification eye hormone treatment, meanwhile, giving the intraocular pressure lowering drug to treat corticosteroid induced ocular hypertension. During the reducing corticosteroid process, scleritis recurrent several times and intraocular pressure has not been smoothly controlled. After consultation from Zhongshan Medical University eye specialist on 8.31, we decided to add the use of cyclosporin A to control the disease started on 9.15. At the same time, gradually reduced local and systemic hormones combined with cardiovascular, endocrine, digestive, renal medicine treatments respond to corresponding complications.
Discharge: Right eye with blurry vision field, no obvious pain, tenderness. Physical examination: stable vital signs, VOD:1.0 (correction), VOS:1.5 (correction). Binocular conjunctival edema obviously, no obvious hyperemia. B ultrasound showed thickness of temporal side wall of right eye ball 1.5MM, left temporal side eye ball wall 1.2MM, right eye fundus examination of optic disc shows clear boundary, the superior temporal branch of artery sclerosis and shows copper wire reflection
Discharge medication: methylprednisolone and cyclosporine A treatment:
(1)cyclosporine A 50MG BID PO until 3.15
(2)methylprednisolone tablets 11.30 2.5# QD, 12.15 2# QD, 12.30 1.5# QD,
1.14 1# QD, 2.13 0.5# QD, 3.15 drug withdrawal
I can't find a ophthalmologist who is specialized in treating this kind of disease, so I post it here for help.
No doctors appear to be responding here at this time.
The questions you ask are indeed the business of a specialist. I suggest you consult with an ophthalmologist in person.
The questions you ask are indeed the business of a specialist. I suggest you consult with an ophthalmologist in person.
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