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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