title: [Bilateral non-arteritic ischemic optic neuropathy during treatment of viral hepatitis C with pegylated interferon and Ribavirin].
abstract: BACKGROUND
  Hepatitis C is a serious viral infection, for which the current treatment is based on the combination of pegylated interferon (IFN) and Ribavirin(®). Ophthalmic complications observed with PEG-IFN are infrequent and of variable prognosis. They often include an ischemic retinopathy with typical cotton-wool spots, hemorrhage and retinal edema, and rarely acute non-arteritic anterior ischemic optic neuropathy as illustrated by our report.
  
  
  METHODS
  We report the case of a 51-year-old man followed for chronic active hepatitis C, who presented in the fourth month of treatment with pegylated interferon and vidarabine with a sharp decline in visual acuity secondary to acute bilateral non-arteritic anterior ischemic optic neuropathy. The hepatitis C treatment was discontinued. His course was notable by the third week for a significant regression of papilledema with improvement in visual acuity in the right eye and no change in the left eye, remaining at counting fingers. After regressing for four years, the disease progressed to bilateral temporal optic atrophy without change in visual acuity.
  
  
  CONCLUSIONS
  Pegylated interferon and Ribavirin(®) are commonly used in the treatment of chronic hepatitis C. They are the source of various ophthalmologic complications of varied severity. The pathophysiology of this ocular toxicity currently remains hypothetical. Non-arteritic ischemic optic neuropathy is still a relatively rare complication with a poor functional prognosis, often requiring discontinuation of treatment. Thus, careful ophthalmologic monitoring before and during antiviral treatment of patients with hepatitis C appears necessary.
authors.affiliation: Service d'ophtalmologie, hôpital militaire d'instruction Mohamed V, Madinat Al Irfane, Rabat, Maroc. Electronic address: Said2214@Yahoo.Fr.
authors.forename: S
authors.initials: S
authors.lastname: Iferkhass
authors.affiliation: Service d'ophtalmologie, hôpital militaire d'instruction Mohamed V, Madinat Al Irfane, Rabat, Maroc.
authors.forename: F
authors.initials: F
authors.lastname: Elasri
authors.affiliation: Service d'ophtalmologie, hôpital militaire d'instruction Mohamed V, Madinat Al Irfane, Rabat, Maroc.
authors.forename: S
authors.initials: S
authors.lastname: Chatioui
authors.affiliation: Service d'ophtalmologie, hôpital militaire d'instruction Mohamed V, Madinat Al Irfane, Rabat, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Khoyaali
authors.affiliation: Service d'ophtalmologie, hôpital militaire d'instruction Mohamed V, Madinat Al Irfane, Rabat, Maroc.
authors.forename: T
authors.initials: T
authors.lastname: Bargach
authors.affiliation: Service d'ophtalmologie, hôpital militaire d'instruction Mohamed V, Madinat Al Irfane, Rabat, Maroc.
authors.forename: K
authors.initials: K
authors.lastname: Reda
authors.affiliation: Service d'ophtalmologie, hôpital militaire d'instruction Mohamed V, Madinat Al Irfane, Rabat, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Oubaaz
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005451:Fluorescein Angiography; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009896:Optic Atrophy / Q000209:etiology; D018917:Optic Neuropathy, Ischemic / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D010211:Papilledema / Q000139:chemically induced; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011859:Radiography; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D012254:Ribavirin
keywords: Chronic viral hepatitis C; Hépatite virale C chronique; Interferon; Interféron; Neuropathie optique antérieure ischémique non artéritique; Non arteritic anterior ischemic optic neuropathy; Vidarabine