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Cotton wool eyes sx - what happens now?!
Just finished week 8 of triple tx and been managing sx so far. Now, theres a couple of cotton wool spots on 1 eye and a bleed. Had late optometrist appt so liver doc hasn't had time to consult properly. He says to take interferon shot tonight as per usual, nurse not so sure - says maybe wait to take shot on Monday, once doc has had a chance to discuss with opthamologist. Don't know if this is permanent or temporary but i sure don't want to risk any permanent damage to my eyesight. Have been trolling previous posts but can't find anything about whether you reduce or stop interferon and what impact that has on svr within the one thread. Is it in fact the interferon or could it be the riba also? Tis disappointing at this stage seeing as I've managed to hold it together so far and only have 4 more weeks of the incivek.
So great to hear. Keep up the good work. I finished a week ago today. Tuesday and Wednesday I felt like superwoman. Zumba, Pilates,dinner with friends, now I'm wiped out. I guess taking it a little slower is the way to recover. Oh well, I had fun and I felt like my old self. We will recover. Yay!
Go figure - Opthalmologist checked my eyes yesterday. She said they are Better than when she checked them 2 weeks ago. They do feel not so "burnt" anymore but nothing has changed in my routine.
Tis positive news :-)
Tis positive news :-)
great news for you too @sph0611 with your end date being just around the corner! Totally agree with you about the sx. Just when you think the sx have settled down there's always a new one that comes to visit.
Great news! Yes it is hell but luckily there is an end date.....mine being just around the corner. Yay! Just took a giant step and cut all my hair off. Yikes. This tx is all encompassing. If its not your eyes it's your skin if its not your skin it's your hair etc etc......
Good news - eye spec just called to say I can continue tx and she will keep me under monitor during tx.
They have all consulted together (the various specialists) so I am confident in their decision.
Am happy to be continuing this hell tx - <> if its not one thing its another.
Thank you for all your posts. I really value and appreciate everyone's input.
It is a hell time when you don't know what's going on and am waiting waiting for news.
thank you!!!
They have all consulted together (the various specialists) so I am confident in their decision.
Am happy to be continuing this hell tx - <> if its not one thing its another.
Thank you for all your posts. I really value and appreciate everyone's input.
It is a hell time when you don't know what's going on and am waiting waiting for news.
thank you!!!
Cotton wool spots are possibly more common than reported because they often only affect peripheral vision and may go unnoticed by the patient.
I developed the spots twice, first time they were in my direct field of view and I was taken off treatment. They faded over the course of 1 or 2 years and by 3 years I found it hard to detect them (in both eyes).
The second time I did not report the spots (foolish) as they were small and outside my direct field of view. They got no worse during treatment.
It is my experience that they will clear up or fade after treatment ends, but that was just my experience. They definitely need monitoring if you develop them while on treatment as continued treatment may cause them to grow. They can make you partially blind (or worse, if at least for a few months/years) in one or both eyes if they happen to form in a certain spot in your eye(s).
I developed the spots twice, first time they were in my direct field of view and I was taken off treatment. They faded over the course of 1 or 2 years and by 3 years I found it hard to detect them (in both eyes).
The second time I did not report the spots (foolish) as they were small and outside my direct field of view. They got no worse during treatment.
It is my experience that they will clear up or fade after treatment ends, but that was just my experience. They definitely need monitoring if you develop them while on treatment as continued treatment may cause them to grow. They can make you partially blind (or worse, if at least for a few months/years) in one or both eyes if they happen to form in a certain spot in your eye(s).
one more week to go for you. That is awesome. You're just about there. :-)
I can relate about the hair!
I have appt with the opthalmologist first thing in the morning. They got me an urgent appt so that's great.
Will post how I got on.
Thanks everyone!
I can relate about the hair!
I have appt with the opthalmologist first thing in the morning. They got me an urgent appt so that's great.
Will post how I got on.
Thanks everyone!
I found out last week I also have cotton wool spots. My ophthalmologist and liver doc both said it was safe to finish treatment. I have one spot in each eye. No pain or vision problems. I did my 23rd shot on Friday. One to go and I'm done! As I sit here on peg Sunday (I always feel worse on Sundays) scratching and trying to keep what's left of my hair on my head all I can say is I'm soooooo ready for the 24th and last shot this Friday. Bring it on. Hope you get to finish.
Hi pooh,
this was only discovered late on Fri so liver doc is discussing with opthamologist this morning. (Is Monday here now) I have an urgent appt with the opthamologist and someone will ring me this morning with how to proceed in the meantime. Funny, I don't have any headache/migrane with it.
this was only discovered late on Fri so liver doc is discussing with opthamologist this morning. (Is Monday here now) I have an urgent appt with the opthamologist and someone will ring me this morning with how to proceed in the meantime. Funny, I don't have any headache/migrane with it.
Just wondering, did you see an opthamologist who is a retina specialist? That is the type of opthamologist you need to see if you have not seen one already. Did he/she do a retinal scan? It is the bleed you mentioned that I would be most concerned with, although the cotton wool spots are also of note. If it was me I would want the Hepatologist to have a thorough discussion with the opthamologist retinal specialist to be sure that everyone is on the same page and understands if this is serious or not.
http://www.rxlist.com/pegasys-drug/warnings-precautions.htm
"Ophthalmologic Disorders"
"Decrease or loss of vision, retinopathy including macular edema, retinal artery or vein thrombosis, retinal hemorrhages and cotton wool spots, optic neuritis, papilledema and serous retinal detachment are induced or aggravated by treatment with PEGASYS or other alpha interferons. All patients should receive an eye examination at baseline. Patients with pre-existing Ophthalmologic disorders (e.g., diabetic or hypertensive retinopathy) should receive periodic Ophthalmologic exams during interferon alpha treatment. Any patient who develops ocular symptoms should receive a prompt and complete eye examination. PEGASYS treatment should be discontinued in patients who develop new or worsening Ophthalmologic disorders."
Same from Drugs.com
"Ophthalmologic Disorders"
"Decrease or loss of vision, retinopathy including macular edema, retinal artery or vein thrombosis, retinal hemorrhages and cotton wool spots, optic neuritis, papilledema and serous retinal detachment are induced or aggravated by treatment with Pegasys or other alpha interferons. All patients should receive an eye examination at baseline. Patients with pre-existing ophthalmologic disorders (e.g., diabetic or hypertensive retinopathy) should receive periodic ophthalmologic exams during interferon alpha treatment. Any patient who develops ocular symptoms should receive a prompt and complete eye examination. Pegasys treatment should be discontinued in patients who develop new or worsening ophthalmologic disorders."
http://www.drugs.com/pro/pegasys.html
http://www.rxlist.com/pegasys-drug/warnings-precautions.htm
"Ophthalmologic Disorders"
"Decrease or loss of vision, retinopathy including macular edema, retinal artery or vein thrombosis, retinal hemorrhages and cotton wool spots, optic neuritis, papilledema and serous retinal detachment are induced or aggravated by treatment with PEGASYS or other alpha interferons. All patients should receive an eye examination at baseline. Patients with pre-existing Ophthalmologic disorders (e.g., diabetic or hypertensive retinopathy) should receive periodic Ophthalmologic exams during interferon alpha treatment. Any patient who develops ocular symptoms should receive a prompt and complete eye examination. PEGASYS treatment should be discontinued in patients who develop new or worsening Ophthalmologic disorders."
Same from Drugs.com
"Ophthalmologic Disorders"
"Decrease or loss of vision, retinopathy including macular edema, retinal artery or vein thrombosis, retinal hemorrhages and cotton wool spots, optic neuritis, papilledema and serous retinal detachment are induced or aggravated by treatment with Pegasys or other alpha interferons. All patients should receive an eye examination at baseline. Patients with pre-existing ophthalmologic disorders (e.g., diabetic or hypertensive retinopathy) should receive periodic ophthalmologic exams during interferon alpha treatment. Any patient who develops ocular symptoms should receive a prompt and complete eye examination. Pegasys treatment should be discontinued in patients who develop new or worsening ophthalmologic disorders."
http://www.drugs.com/pro/pegasys.html
http://hcvets.com/data/hcv_liver/eyes.htm
Cotton-wool spots were found in 31 patients and retinal hemorrhage in nine patients during treatment (24% of patients). These lesions remained asymptomatic and disappeared in all patients. A previous history of arterial hypertension (RR 4.60, 95% CI 1.95-10.85), age above 45 years (RR 2.80, 95% CI 1.36-5.85), and use of pegylated alpha-interferon (RR 2.75, 95% CI 1.41-5.38) were significantly associated with retinopathy. Neurovisual impairment was present in 31 patients (20%) before treatment and in 74 patients (47%) during treatment.
In studies including a significant number of diabetic patients [5,7] diabetes mellitus has also been associated with retinopathy. Furthermore, improvement of retinopathy is delayed in hypertensive and diabetic patients after ending treatment [7]. This relationship emphasizes that IFN-induced retinopathy can result from physiopathological mechanisms in common with other retinopathies related to microvascular abnormalities.
Conclusions: In conclusion, this study showed that signs of retinopathy and neurovisual impairment were common in patients receiving alpha-interferon therapy but were rarely symptomatic. It suggests that alpha-interferon may usually be continued in asymptomatic patients as long as there is careful fundoscopic examination.
Cotton-wool spots were found in 31 patients and retinal hemorrhage in nine patients during treatment (24% of patients). These lesions remained asymptomatic and disappeared in all patients. A previous history of arterial hypertension (RR 4.60, 95% CI 1.95-10.85), age above 45 years (RR 2.80, 95% CI 1.36-5.85), and use of pegylated alpha-interferon (RR 2.75, 95% CI 1.41-5.38) were significantly associated with retinopathy. Neurovisual impairment was present in 31 patients (20%) before treatment and in 74 patients (47%) during treatment.
In studies including a significant number of diabetic patients [5,7] diabetes mellitus has also been associated with retinopathy. Furthermore, improvement of retinopathy is delayed in hypertensive and diabetic patients after ending treatment [7]. This relationship emphasizes that IFN-induced retinopathy can result from physiopathological mechanisms in common with other retinopathies related to microvascular abnormalities.
Conclusions: In conclusion, this study showed that signs of retinopathy and neurovisual impairment were common in patients receiving alpha-interferon therapy but were rarely symptomatic. It suggests that alpha-interferon may usually be continued in asymptomatic patients as long as there is careful fundoscopic examination.
Hi Billy,
gosh that must've been frightening going through that.I would've freaked not being able to see for 45 mins. Glad you are ok now!!!
I've had an episode where i couldn't see for about 1/2 a minute even though my eyes were open. I've had a couple of times where i couldn't read some txt on my pc or on my phone - when I moved my eyes to try to read the txt, the blind spot just moved to other words on that line. There has been no headache or pain associated with this so far.
So you managed svr even so by looks of it? Thats fantastic.
gosh that must've been frightening going through that.I would've freaked not being able to see for 45 mins. Glad you are ok now!!!
I've had an episode where i couldn't see for about 1/2 a minute even though my eyes were open. I've had a couple of times where i couldn't read some txt on my pc or on my phone - when I moved my eyes to try to read the txt, the blind spot just moved to other words on that line. There has been no headache or pain associated with this so far.
So you managed svr even so by looks of it? Thats fantastic.
i had them....was taken off tx at 19 weeks because of it....if they aren't too bad you'll probably be able to stay on tx but be careful....my eyes are fine now post tx....last eye exam i had was at 6 months post and most of it was gone...........when it got bad it doubled me over in pain....the bad pain was about 5 to 20 seconds...and about 5 minutes to get over....when i went in to get my eyes checked out the doctor took a quick look and said...you did the right thing coming in ....even before he compared the before tx pictures....i was taken off tx that day...just really be careful..your probably fine as cotton wool spots are common on interferon...did you lose your sight at all during tx? once i couldn't see for about 45 minutes just a blur...not sure if that was because of the bleeding.....good luck....billy
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