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[Bilateral AION after the combined therapy of hepatitis C with PEG-interferon alpha2B and ribavirin]
A Kirchhoff1, U Kirchhoff, M Lafrenz
1Augenklinik und Poliklinik der Universität Rostock. dr-kirchhoff@augenarzt-row.de
Introduction:
Chronic hepatitis C-therapy is limited to the combined use of PEG-ylated interferons and ribavirin. Side effects of this therapy include retinal changes that manifest with bleeding, cotton wool spots and/or thrombosis.
Patient:
A 51-year-old man presented with a sudden decrease of visual acuity. Chronic hepatitis C was known for the duration of 6 months and treated for 3 months with a combined therapy of PEG-interferon alpha2B and ribavirin. A sudden visual loss occurred in the right eye and bilateral visual field defects were detected. Ophthalmoscopic examination revealed bilateral papilloedema. After withdrawal of PEG-interferon alpha2B and ribavirin, a standard haemodilution therapy was started without functional improvement. After papilloedema regression, a beginning secondary atrophy of the optic nerve was diagnosed bilaterally. Vision did not improve.
Conclusion:
The ocular side effects of combined hepatitis C therapy with PEG-interferon alpha2B and ribavirin range from mild retinal changes to severely impaired vision. Treatment should be carried out in co-operation with an ophthalmologist. With respect to the uncertain effectiveness of hepatitis C therapy with interferon alpha2B and ribavirin, therapy should be stopped as soon as severe ophthalmological complications occur.
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