[Bilateral AION after the combined therapy of hepatitis C with PEG-interferon alpha2B and ribavirin].
BACKGROUND
Chronic hepatitis C-therapy is limited to the combined use of PEG-ylated interferons and ribavirin. Side effects of this therapy include retinal changes that manifest with bleeding, cotton wool spots and/or thrombosis.


METHODS
A 51-year-old man presented with a sudden decrease of visual acuity. Chronic hepatitis C was known for the duration of 6 months and treated for 3 months with a combined therapy of PEG-interferon alpha2B and ribavirin. A sudden visual loss occurred in the right eye and bilateral visual field defects were detected. Ophthalmoscopic examination revealed bilateral papilloedema. After withdrawal of PEG-interferon alpha2B and ribavirin, a standard haemodilution therapy was started without functional improvement. After papilloedema regression, a beginning secondary atrophy of the optic nerve was diagnosed bilaterally. Vision did not improve.


CONCLUSIONS
The ocular side effects of combined hepatitis C therapy with PEG-interferon alpha2B and ribavirin range from mild retinal changes to severely impaired vision. Treatment should be carried out in co-operation with an ophthalmologist. With respect to the uncertain effectiveness of hepatitis C therapy with interferon alpha2B and ribavirin, therapy should be stopped as soon as severe ophthalmological complications occur.
Kirchhoff
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A
Augenklinik und Poliklinik der Universität Rostock. dr-kirchhoff@augenarzt-row.de
Kirchhoff
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U
Lafrenz
M
M
Guthoff
R
R
D000998:Antiviral Agents / Q000008:administration & dosage / Q000633:toxicity*; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000633:toxicity*; D008297:Male; D008875:Middle Aged; D009896:Optic Atrophy / Q000139:chemically induced* / Q000175:diagnosis; D018917:Optic Neuropathy, Ischemic / Q000139:chemically induced* / Q000175:diagnosis; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000633:toxicity*; D014792:Visual Acuity / Q000187:drug effects; D014794:Visual Fields / Q000187:drug effects
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b