Efficacy and tolerability of interferon alpha treatment in patients with chronic cystoid macular oedema due to non-infectious uveitis

• Published in: British journal of ophthalmology Vol. 93; no. 7; pp. 906 - 913
• Main Authors: Deuter, C M E, Kötter, I, Günaydin, I, Stübiger, N, Doycheva, D G, Zierhut, M
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.07.2009; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Antiviral Agents - therapeutic use; Biological and medical sciences; Chronic Disease; Drug Administration Schedule; Drug dosages; Endothelium; Enzymes; Female; Humans; Inflammation; Interferon-alpha - therapeutic use; Macular Edema - drug therapy; Male; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Quality of life; Retrospective Studies; Tomography, Optical Coherence; Treatment Outcome; Uvea diseases; Uveitis - complications; Visual Acuity - physiology; Human; Infection; Macula; Eye disease; Chronic; Treatment; Cytokine; Uveitis; Uvea disease; Interferon; Ophthalmology
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2008.153874

Aim:To assess the efficacy and tolerability of interferon (IFN) alpha in chronic cystoid macular oedema (CMO) due to non-infectious uveitis.Methods:Retrospective analysis of an interventional case series. IFN alpha-2a was administered at an initial dose of 3 or 6 million IU per day subcutaneously and tapered afterwards to the lowest possible dose to maintain the absence of CMO. Treatment efficacy was assessed by optical coherence tomography.Results:Twenty-four patients with chronic CMO (median duration 36.0 months) due to non-infectious anterior (n = 2), intermediate (n = 18) or posterior (n = 4) uveitis have been analysed. Ineffective pretreatment included systemic corticosteroids (all patients), acetazolamide (22 patients) and at least one immunosuppressive drug (18 patients). IFN therapy was shown to be effective ( = complete resolution of CMO within 3 months, able to taper IFN) in 15 patients (62.5%), partly effective ( = incomplete resolution of CMO, unable to taper IFN) in six patients (25.0%) and not effective ( = no response or recurrence of CMO) in three patients (12.5%). IFN treatment was generally well tolerated. Common side effects including flu-like symptoms, fatigue or increased liver enzymes were dose-dependent and led to discontinuation of IFN in only one patient.Conclusion:The data demonstrate IFN alpha to be an effective and well-tolerated therapy for chronic refractory uveitic CMO.