title: Bilateral retrobulbar optic neuropathy in the setting of interferon alpha-2a therapy.
abstract: The development of biopharmaceutical agents, including the interferons (IFN), offers new treatment options for a wide range of medical conditions. Such advancements, however, have not come without risk to patients. Optic neuropathy in the setting of IFN therapy has been previously documented and is usually attributed to anterior ischaemic optic neuropathy; however, the pathophysiology remains poorly understood. Retrobulbar optic neuropathy associated with IFN treatment has not been described in the medical literature to date. We report the case of a 38-year-old Caucasian female with refractory acute myeloid leukaemia who developed painless bilateral blurred vision within 2 weeks of commencing a course of IFN alpha-2a. Extensive clinical workup demonstrated bilateral retrobulbar optic neuropathy. We report the clinical evaluation of this first documented case and discuss the possible aetiologies of her presentation.
authors.affiliation: Department of Ophthalmology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Vic., Australia.
authors.forename: Dujon R W
authors.initials: DR
authors.lastname: Fuzzard
authors.affiliation: Departments of Ophthalmology, University of Melbourne, Parkville, Vic., Australia.
authors.forename: Heather G
authors.initials: HG
authors.lastname: Mack
authors.affiliation: Department of Ophthalmology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Vic., Australia ; Departments of Surgery (RMH), University of Melbourne, Parkville, Vic., Australia.
authors.forename: R C Andrew
authors.initials: RC
authors.lastname: Symons
keywords: Adverse drug reaction; Anti-drug antibody; Interferon alpha; Optic neuropathy; Retrobulbar