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Br J Ophthalmol doi:10.1136/bjo.2008.153874

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

  1. Christoph M E Deuter (christoph.deuter{at}med.uni-tuebingen.de),
  2. Ina Kötter (ina.koetter{at}med.uni-tuebingen.de),
  3. Ilhan Günaydin (ilhan.guenaydin{at}med.uni-tuebingen.de),
  4. Nicole Stübiger (nicole.stuebiger{at}med.uni-tuebingen.de),
  5. Deshka G Doycheva (deshka.doycheva{at}med.uni-tuebingen.de),
  6. Manfred Zierhut (manfred.zierhut{at}med.uni-tuebingen.de)
  1. Centre for Ophthalmology, University of Tübingen, Germany
  2. Department of Internal Medicine II, University of Tübingen, Germany
  3. Department of Internal Medicine II, University of Tübingen, Germany
  4. Centre for Ophthalmology, University of Tübingen, Germany
  5. Centre for Ophthalmology, University of Tübingen, Germany
  6. Centre for Ophthalmology, University of Tübingen, Germany
    • Published Online First 24 March 2009

    Abstract

    Aim: To assess the efficacy and tolerability of interferon (IFN) alpha in chronic cystoid macular edema (CME) 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 CME. Treatment efficacy was assessed by optical coherence tomography.

    Results: Twenty-four patients with chronic CME (median duration 36.0 months) due to non-infectious anterior (n=2), intermediate (n=18) or posterior (n=4) uveitis have been analysed. Ineffective pre-treatment 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 CME within 3 months, able to taper IFN) in 15 patients (62.5%), partly effective (= incomplete resolution of CME, unable to taper IFN) in 6 patients (25.0%) and not effective (= no response or recurrence of CME) in 3 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 1 patient.

    Conclusion: Our data demonstrate IFN alpha to be an effective and well-tolerated therapy for chronic refractory uveitic CME.

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