Interferon-alpha as an effective treatment for noninfectious posterior uveitis and panuveitis.
OBJECTIVE
Several studies have shown the capacity of interferon-alpha (IFN-alpha) to control ocular Behçet disease. The authors aimed to determine whether IFN-alpha was effective in treating patients with severe, refractory sight-threatening intraocular inflammation (uveitis) from a wider range of causes, including Behçet disease.


METHODS
Prospective, interventional case series.


METHODS
Twelve patients with sight-threatening uveitis that failed to respond to one or more immunosuppressive regimens were enrolled to this study. Recombinant human IFN-alpha-2b was administered subcutaneously daily, and the dose was adjusted according to the clinical response. Main outcome measures were visual acuity, clinical activity of uveitis (including binocular indirect ophthalmoscopy [BIO] score and presence or absence of macular edema), and adverse effects of the treatment.


RESULTS
The mean observation period was 11 months (range, one to 29 months). A positive clinical response was observed in 83% of patients. Median visual acuity improved from 0.54 to 0.2 (logarithm of the minimum angle of resolution units; P < .001) and median BIO score decreased from 1.0 to 0.5 (P < .05) within one month of treatment. Macular edema, if present, resolved in all patients within days of treatment. The main adverse events were tiredness, lymphopenia, flu-like symptoms, and transient increase of liver enzymes. Weight loss occurred in four patients. Four patients experienced depression, one of them attempting suicide. Three patients experienced typical features of IFN-alpha-associated retinopathy, which resolved on reducing the dose.


CONCLUSIONS
IFN-alpha seems to have significant potential in treatment of severe, sight-threatening refractory uveitis from a variety of causes. A range of adverse events, including IFN-alpha-associated retinopathy, may occur and could limit the use of this immunomodulatory drug.
Plskova
Jarka
J
Department of Ophthalmology, University of Aberdeen, Aberdeen, Scotland, United Kingdom.
Greiner
Kathrin
K
Forrester
John V
JV
D000293:Adolescent; D000328:Adult; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015864:Panuveitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D011994:Recombinant Proteins; D016896:Treatment Outcome; D015866:Uveitis, Posterior / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014792:Visual Acuity
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins