dear professor forste
i am a hematologist living in israel. my sun 19 year old age, he complained of left eye visual disturbance 7 months ago, the ophtalmologist examined him and the diagnosis was anterior uveitis, vitritis with macular edema. he was treated by prednisone pills, atropin drops, and steroid drop. after one month of treatment, he felt good, and the treatment gradully stoped. one week afetr treatment stoping he feels again visual disturbance with left red eye. the ophtalmologist diagnosed recurrent uveitis . the flurocent angiography showed exudate of both retinal vessele more in left eye, with CME and warm disc in left side. the diagnosis was posterior uveitis. the prednisone dosage increase to 60 mg daily, at follw up all sign of inflammation was disappeard. the prednison gradullaly taperd in 6 month' but 3 weeks after taking 5 mg prednisone , relapse of anterior and posterio uveitis occurs in tha left eye. the ohptalmologis recomanded to increase the prednisone dosage to 20 mg , and he also recomended immunosupressive drug like azthioprine or metotrxate.in the past history he sufferd from bucal ophtus occasionally, without joint pain,the HLA B51 is positive, the sacroilliac and spinal x ray is normal. the reumatolosist told me, there is suspicious of behcet diseae but except of uveitis he dose not have any more problem and in recent months onl one time he suffered frome bucal ophtus.
bisides this all of autoimmune tests were nromal. and toxoplasma test was negative.
i ask you to give me consultation. if he must to take immunosupressive drug like azathioprine or metotrexate or only to take prednisone' but this time to put hus in 10 mg prednisone maintenence.
thank you for your reply
dr yeganeh shay
i am a hematologist living in israel. my sun 19 year old age, he complained of left eye visual disturbance 7 months ago, the ophtalmologist examined him and the diagnosis was anterior uveitis, vitritis with macular edema. he was treated by prednisone pills, atropin drops, and steroid drop. after one month of treatment, he felt good, and the treatment gradully stoped. one week afetr treatment stoping he feels again visual disturbance with left red eye. the ophtalmologist diagnosed recurrent uveitis . the flurocent angiography showed exudate of both retinal vessele more in left eye, with CME and warm disc in left side. the diagnosis was posterior uveitis. the prednisone dosage increase to 60 mg daily, at follw up all sign of inflammation was disappeard. the prednison gradullaly taperd in 6 month' but 3 weeks after taking 5 mg prednisone , relapse of anterior and posterio uveitis occurs in tha left eye. the ohptalmologis recomanded to increase the prednisone dosage to 20 mg , and he also recomended immunosupressive drug like azthioprine or metotrxate.in the past history he sufferd from bucal ophtus occasionally, without joint pain,the HLA B51 is positive, the sacroilliac and spinal x ray is normal. the reumatolosist told me, there is suspicious of behcet diseae but except of uveitis he dose not have any more problem and in recent months onl one time he suffered frome bucal ophtus.
bisides this all of autoimmune tests were nromal. and toxoplasma test was negative.
i ask you to give me consultation. if he must to take immunosupressive drug like azathioprine or metotrexate or only to take prednisone' but this time to put hus in 10 mg prednisone maintenence.
thank you for your reply
dr yeganeh shay
