title: [Interferon-alpha toxicity and reversible bilateral optical neuropathy: a timely withdrawal of the drug].
abstract: Clinical case A patient with chronic, painless, bilateral loss of vision, after significant intake of interferon (IFNα) and ribavirina due to liver transplant. Ocular fundus is normal. A suspected retrobulbar optic neuropathy is confirmed by a prolongation of the latency of the patient's visual evoked potential. There being no prior record of risk factors and with the patient's systemic analysis giving normal results, the clinical improvement and the electro-physiological tests conducted after the drug was withdrawn point to interferon as negatively affecting the bilateral optic nerve. Discussion Interferon-α is used in the treatment of viral and neoplastic illnesses. Currently the drug is formulated as Interferon alfa pegilado (IFNα-p) in order to reduce toxicity and increase tolerance. The most common secondary effects are flu symptoms, asthenia and weigh loss. Affected ocular tissue is rare and optic neuropathy is also an infrequent complication: retinopathy at the beginning of treatment is, however, more frequent. The most widely accepted hypothesis as to the cause of toxicity is the presence of circulating immune complexes. It is, therefore, essential for ophthalmologists to be aware of the toxicity of this drug in order to be able to withdraw it in good time, thus preventing potentially irreversible sight loss.
authors.affiliation: Servicio de Oftalmología, Hospital Valle del Nalón, Langreo, Asturias, España. Electronic address: gemurri27@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Pérez-Carro
authors.affiliation: Servicio de Neurofisiología, Facultativo Especialista de Área, Hospital Valle del Nalón, Langreo, España.
authors.forename: R
authors.initials: R
authors.lastname: Fernández-Alonso
authors.affiliation: Servicio de Digestivo, Área de Hepatología, Hospital Universitario de Asturias, Asturias, España.
authors.forename: M L
authors.initials: ML
authors.lastname: González-Diéguez
authors.affiliation: Servicio de Digestivo, Área de Hepatología, Hospital Universitario de Asturias, Asturias, España.
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-García
authors.affiliation: Servicio de Oftalmología, Hospital Valle del Nalón, Langreo, Asturias, España.
authors.forename: J
authors.initials: J
authors.lastname: Junceda-Moreno
mesh_terms: D000328:Adult; D005074:Evoked Potentials, Visual; D005168:Factor VII Deficiency / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016031:Liver Transplantation; D009902:Optic Neuritis / Q000139:chemically induced* / Q000175:diagnosis; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis; D011930:Reaction Time; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D014786:Vision Disorders / Q000209:etiology*
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b
keywords: Chronic hepatitis due to VHC; Evoked visual potentials; Hepatitis crónica por VHC; Interferón alfa pegilado; Latencia prolongada; Neuropatía óptica tóxica; Pegylated Interferon alpha; Potenciales evocados visuales; Prolonged latency; Toxic optical neuropathy