UK prospective study of change in visual function in patients treated with Peginterferon alpha for hepatitis C

Abstract

Introduction Hepatitis C virus and interferon treatment have been associated with retinopathy and so baseline and ongoing assessment by ophthalmologists has been advocated in previous studies. Our experience suggested that the incidence is low with no or negligible impact of pegylated Interferon alpha on actual visual function. This study was conducted to determine whether ophthalmic assessment is necessary in such patients.

Methods Prospective case series with initial cohort of 52 patients (104 eyes). Visual acuity, contrast sensitivity, colour vision, visual field by perimetry and fundal assessment were taken at baseline and at 3 and 6 months post commencement of interferon alpha treatment.

Results Full follow-up data for contrast sensitivity,colour vision and fundoscopy was available on 38 patients and for perimetry in 35 patients. No patients reported any subjective visual symptoms. The mean changes in right and left LogMAR visual acuity were negligible between baseline and 6 months at 0.05 (SD 0.13) and 0.10 (SD 0.12). Mean changes in contrast sensitivity and colour vision were also negligible. Of all eyes monitored by serial perimetry for the full follow-up period and with reliable test indices, none developed visual field defects. 1 patient appeared to develop nasal field defects within 3 months of commencing treatment but failed to attend for repeat testing. None developed optic disc changes or permanent fundal changes over the follow-up period.

Conclusion In contrast to previous American and South-East Asian studies, our findings based on a UK cohort suggest that routine ophthalmic screening is not essential for patients with Hepatitis C treated with pegylated interferon alpha who have no subjective visual complaints.