VItamin D and Iritis

[Lulu]

Hi, I've had uncontrolled iritis from April 2009 until November 2010. Only once in that period did i go more than 3 weeks without a bad(always level 3 or 4 and in both eyes or ping-ponging between both eyes) flare up and that was when i was on durezol but it raised my IOP so high that my doc won't let me use it again. I was supposed to go on cellcept last summer (2010), but put it off due to my kid getting some live vaccines and me getting several bad colds. IN august my primary doc checked my vit d level and it was very low. I started on 50,000 iu per week for three months and got my level back up. The interesting thing is that since Nov of 2010 I have only had two minor flare ups resolved with pred forte drops no more than four times a day for a day, then tapering to 0 in four days. I'm wondering if any research is being done or has been done on Vit d deficiency and iritis or if it is just a coincidence that getting my vit d level up and having fewer, less severe flare ups happened at the same time. I now that the goal is no need for steriods for 2 years, so i may still go on cellcept if my opth advises it, but so far, things are surprisingly quiet with my eyes.

[Mike Bartolatz]

I know of no studies on Vitamin D deficiency and Iritis.
have you been tested for the HLA B27 gene which causes allot of iritis cases and a hallmark of which is the ping ponging of inflammation between eyes?

have you tried NSAID therapy such as with Celebrex, dolobid or naprosyn to see if one of them might break the cycle of inflammation?

wish you the very best,
Mike

[Lulu]

I was tested for the HLA B27 gene and many other things back in May of 2009 when my iritis had gone 6 weeks with just a few clear days here and there. Would it make sense to be retested for it now? NSAIDS only masked the pain and then suddenly I'd have blurry vision, go the opthomalogist and find out I had level 3 or 4 of inflammation. Dr. Hinkle wants me on cellcept which I will do if the iritis flares up again badly again. Thanks.

[Mike Bartolatz]

yes, usually Dr foster retests annually for autoimmune diseases if symptoms are present. oddly some autoimmune diseases which have antibody markers can take hears for these markers to appear. when immunomodulated however, these markers are suppressed which keeps the underlying autoimmune disease in active. there are other genes such as the IL23R and ERAP1 genes which can predispose to ankylosing spondylitis, psoriasis and psoriatic arthritis, autoimmune thyroid disease, crohn's disease and breast cancer and possibly others when in conjunction with the IL23R gene as occurs in Behcet's diesease and Systemic Lupus erythematosus. another gene is the IL1R2 gene . IL1B is found in sarcoidosis, diabetes and osteoarthritis.


DR Hinkle should be able to get you quieted down with the cellcept alone or in combination with a TNF A blocking drug such as remicade or humira.
if the IL23R gene is present and you have psoriasis, the drug Stelara which blocks IL23 might be an option. this is a new drug.

wish you the very best,
Mike

[Lulu]

thank you for the info-i'll use it at my next appt to ask to be retested.