Ophthalmological side effects of interferon therapy of chronic hepatitis C.
BACKGROUND
Egypt has one of the highest prevalence of hepatitis C virus (HCV) worldwide. Ophthalmological side effects are recognized complications of interferon (IFN) therapy. This study aimed to evaluate IFN-induced ophthalmological manifestations in patients receiving PEGylated interferon (PEG IFN) and ribavirin (RBV) and to assess the effect of IFN duration, response and systemic risk factors on the severity.


METHODS
We retrospectively analyzed 100 patients with chronic HCV who were candidates for PEG-IFN and RBV therapy. All patients were subjected to clinical and ophthalmological examination, laboratory investigations, abdominal ultrasound, colored fundus photography and fundus fluorescein angiography, follow up was made at weeks 12, 24, and 48 of treatment.


RESULTS
IFN-induced retinopathy had been found in (9/100; 9%), 5 (5/9; 55.5%) of them had bilateral lesions, (3/9; 33.3%) were treatment responders and (6/9; 66.6%) non responders. The time of retinopathy appearance was mainly at W12. Retinopathy was asymptomatic in most of the affected patients (7/9; 77.77%) and reversible, cotton wool spots was the major associated sign. Patients with older age, DM and or HTN, and non-responders to antiviral therapy were associated with more severe retinopathy.


CONCLUSIONS
Retinopathy is not a rare complication of IFN therapy for chronic HCV infection, but fortunately it's asymptomatic and reversible. Ophthalmological assessment at base-line and at follow up during IFN treatment is very important.
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Eman
E
Medhat
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Gamal
G
Esmat
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Eman
E
Hamza
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Amr
A
Abdel Aziz
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Waleed
W
Fouad Fathalah
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Samar Kamal
SK
Darweesh
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Zeinab
Z
Zakaria
1 Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt ; 2 Research Institute of Ophthalmology, Egypt.
Sameh
S
Mostafa
Hepatitis C virus (HCV); fundus fluorescein angiography; interferon (IFN); retinopathy