Pegylated interferon alpha-associated optic neuropathy.
A 52-year-old man with chronic hepatitis C presented with painless, bilateral, simultaneous nonarteritic anterior ischemic optic neuropathy (NAION) and peripheral neuropathy. Symptoms began 19 weeks after starting peginterferon alpha-2a. The peripheral neuropathy and vision of the right eye improved, but the vision of the left eye worsened after stopping interferon. We identified 23 additional cases of NAION during interferon alpha therapy. At least 12 of these patients suffered bilateral NAION. Patients lost vision 1-40 weeks after initiating therapy. Of 21 eyes that had documented initial and follow-up acuities, 8 improved, 1 worsened, and the rest remained stable. One patient had a painful peripheral neuropathy. Treatment with interferon alpha may result in NAION. Discontinuation of therapy deserves consideration after weighing individual risks and benefits.
Berg
Kathleen T
KT
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, USA.
Nelson
Bruce
B
Harrison
Andrew R
AR
McLoon
Linda K
LK
Lee
Michael S
MS
D000998:Antiviral Agents / Q000009:adverse effects; D001284:Atrophy / Q000139:chemically induced / Q000276:immunology / Q000503:physiopathology; D001766:Blindness / Q000139:chemically induced; D006526:Hepatitis C / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D018917:Optic Neuropathy, Ischemic / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D010292:Paresthesia / Q000139:chemically induced / Q000276:immunology / Q000503:physiopathology; D010525:Peripheral Nerves / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D014794:Visual Fields / Q000187:drug effects / Q000502:physiology
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a