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Interferon as a treatment for uveitis associated with multiple sclerosis
  1. M D Becker1,2,
  2. A Heiligenhaus3,
  3. T Hudde4,
  4. B Storch-Hagenlocher5,
  5. B Wildemann5,
  6. T Barisani-Asenbauer6,
  7. C Thimm7,
  8. N Stübiger7,
  9. M Trieschmann3,
  10. C Fiehn1,8
  1. 1Interdisciplinary Uveitis Center, University of Heidelberg, Germany
  2. 2Department of Ophthalmology, University of Heidelberg, Germany
  3. 3Department of Ophthalmology at St Franziskus Hospital, Münster, Germany
  4. 4Department of Ophthalmology, University of Essen, Germany
  5. 5Department of Neurology, University of Heidelberg, Germany
  6. 6Department of Ophthalmology, University of Vienna, Austria
  7. 7Department of Ophthalmology, University of Tübingen, Germany
  8. 8Department of Internal Medicine, University of Heidelberg, Germany and Centre of Rheumatic Diseases, Baden-Baden, Germany
  1. Correspondence to: Matthias D Becker MD, PhD, FEBO, Interdisciplinary Uveitis Center, University of Heidelberg, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany; matthias.beckeruveitiscenter.de

Abstract

Aim: In addition to optic neuritis (ON), multiple sclerosis (MS) may also involve the eye with a typically bilateral intermediate uveitis. The aim of this pilot study was to evaluate the efficacy of type I interferons (IFN) for the treatment of MS associated uveitis.

Methods: In this non-randomised, retrospective observational case series 13 patients (eight female, five male) with proved MS and associated uveitis from five uveitis centres who were treated with interferon β1a were included. Visual acuity (VA), cell count in the aqueous humour and vitreous, as well as the presence of cystoid macula oedema (CMO) were observed.

Results: All except one patient had a bilateral form of intermediate uveitis (total of 24 eyes). Seven patients had documented CMO before IFN treatment (n = 13 eyes). Median duration of treatment was 24.6 months (range 7.9–78.7). VA improved in 17 eyes (comparing VA before therapy and at last follow up); while 10 eyes (36%) improved ⩾3 Snellen lines. Aqueous cell count improved by 1.2 (SD 1.1) grades in all eyes. Vitreous cell count improved by 1.7 (1.4) in all eyes. Only two patients still had minimal CMO on last follow up angiographically. CMO resolved after or during IFN treatment in nine eyes.

Conclusions: IFN has been shown to have beneficial effects in patients with MS and/or ON. As shown in the models of experimental allergic encephalomyelitis (EAE) and uveitis, the neurological and ophthalmological manifestations seem to share similar pathogenic mechanisms. Treatment of MS associated uveitis with IFN appears to have beneficial effects on VA, intraocular inflammation activity, and the presence of CMO.

  • CMO, cystoid macula oedema
  • EAE, experimental allergic encephalomyelitis
  • IFN, interferon
  • MRI, magnetic resonance imaging
  • MS, multiple sclerosis
  • ON, optic neuritis
  • VA, visual acuity
  • uveitis
  • multiple sclerosis
  • interferon
  • therapy
  • human
  • CMO, cystoid macula oedema
  • EAE, experimental allergic encephalomyelitis
  • IFN, interferon
  • MRI, magnetic resonance imaging
  • MS, multiple sclerosis
  • ON, optic neuritis
  • VA, visual acuity
  • uveitis
  • multiple sclerosis
  • interferon
  • therapy
  • human
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