Interferon alfa-associated anterior ischemic optic neuropathy.
OBJECTIVE
To report a possible association between interferon alfa therapy and anterior ischemic optic neuropathy (AION).


METHODS
Database study and review of the literature.


METHODS
Thirty-six case reports from spontaneous reporting systems and the literature.


METHODS
Case reports from a review of the literature were combined with spontaneous reports from the National Registry of Drug-Induced Ocular Side Effects, the World Health Organization, and the Food and Drug Administration looking for reports on interferon therapy associated with optic neuropathy.


METHODS
Data from the spontaneous reports include the type of interferon, age, gender, adverse drug reaction (ADR), dosage, duration of therapy until onset of ADR, concomitant drugs, systemic disease, and dechallenge and rechallenge data.


RESULTS
Thirty-six case reports of AION are described in association with interferon alfa therapy. The average age of subjects was 54.5 years; 26 were male and 10 were female. The median duration of therapy to onset of AION was 4.5 months, with 50% of subjects having some form of permanent vision loss. Anterior ischemic optic neuropathy was bilateral in 67% of subjects. There are 3 positive rechallenge case reports.


CONCLUSIONS
Interferon alfa's association with AION can be classified as "possible" using the World Health Organization classification system. If optic neuropathy is suspected, rapid cessation of interferon therapy may portend a better prognosis because multiple case reports indicate visual defects may be permanent if this possible ADR remains unrecognized.
Fraunfelder
F W
FW
Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239-4197, USA. eyedrug@ohsu.edu
Fraunfelder
F T
FT
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000008:administration & dosage*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000188:drug therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000139:chemically induced*
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D016898:Interferon-alpha