Ophthalmologic side effects during alpha-interferon therapy for viral hepatitis.
OBJECTIVE
Ophthalmologic side effects have been reported during interferon therapy, particularly retinal lesions and neurovisual impairment. The aim of this prospective study was to assess the nature and the frequency of such lesions during alpha-interferon therapy for viral hepatitis.


METHODS
Between 1995 and 2003, 156 patients treated with standard or pegylated alpha-interferon, with or without ribavirin, had a regular ophthalmologic examination before and during treatment. No patient had signs of retinopathy before treatment. 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.


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.
d'Alteroche
Louis
L
Service d'Hépato-Gastroentérologie, Hôpital Trousseau, 37044 Tours cedex, France. l.dalteroche@chu-tours.fr
Majzoub
Samuel
S
Lecuyer
Anne-Isabelle
AI
Delplace
Marie-Paule
MP
Bacq
Yannick
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005074:Evoked Potentials, Visual / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology / Q000503:physiopathology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity
D000998:Antiviral Agents; D016898:Interferon-alpha