| Abstract | PURPOSE: Several studies have shown the capacity of interferon-alpha (IFN-alpha) to control ocular Behçet disease. The authors aimed to determine whether IFN-alpha was effective in treating patients with severe, refractory sight-threatening intraocular inflammation (uveitis) from a wider range of causes, including Behçet disease. DESIGN: Prospective, interventional case series. METHODS: Twelve patients with sight-threatening uveitis that failed to respond to one or more immunosuppressive regimens were enrolled to this study. Recombinant human IFN-alpha-2b was administered subcutaneously daily, and the dose was adjusted according to the clinical response. Main outcome measures were visual acuity, clinical activity of uveitis (including binocular indirect ophthalmoscopy [BIO] score and presence or absence of macular edema), and adverse effects of the treatment. RESULTS: The mean observation period was 11 months (range, one to 29 months). A positive clinical response was observed in 83% of patients. Median visual acuity improved from 0.54 to 0.2 (logarithm of the minimum angle of resolution units; P < .001) and median BIO score decreased from 1.0 to 0.5 (P < .05) within one month of treatment. Macular edema, if present, resolved in all patients within days of treatment. The main adverse events were tiredness, lymphopenia, flu-like symptoms, and transient increase of liver enzymes. Weight loss occurred in four patients. Four patients experienced depression, one of them attempting suicide. Three patients experienced typical features of IFN-alpha-associated retinopathy, which resolved on reducing the dose. CONCLUSIONS: IFN-alpha seems to have significant potential in treatment of severe, sight-threatening refractory uveitis from a variety of causes. A range of adverse events, including IFN-alpha-associated retinopathy, may occur and could limit the use of this immunomodulatory drug. |
| Authors | Jarka Plskova, Kathrin Greiner, John V Forrester
(Affiliation: Department of Ophthalmology, University of Aberdeen, Aberdeen, Scotland, United Kingdom.)
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| Journal | American journal of ophthalmology
(Am J Ophthalmol)
Vol. 144
Issue 1
Pg. 55-61
(Jul 2007)
ISSN: 0002-9394 United States |
| PMID | 17601428
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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| Chemical References |
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| Topics |
- Adolescent
- Adult
- Female
- Fluorescein Angiography
- Humans
- Interferon Alfa-2b
(adverse effects, therapeutic use)
- Male
- Middle Aged
- Panuveitis
(diagnosis, drug therapy, etiology)
- Prospective Studies
- Treatment Outcome
- Uveitis, Posterior
(diagnosis, drug therapy, etiology)
- Visual Acuity
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