[Interferon causes ischemic ocular diseases--case studies and review of the literature]

Reports of interferon-associated retinopathy mainly originate from Japanese working groups. Only a few cases have been described in Europe.

We have performed a retrospective analysis of the patients who were examined in the University Eye Clinic in Mainz complaining of visual loss associated with systemic interferon therapy in the time span between January 2001 and December 2003.

12 patients (age 35 - 67 years), undergoing treatment with interferon alpha for hepatitis C, metastatic renal cell carcinoma, leukaemia and malignant melanoma of the skin, complained of blurred vision 2 - 10 weeks after the start of interferon therapy. Fundus examination revealed retinal haemorrhages and cotton-wool spots in all eyes. Additionally in some eyes macular edema, retinal arteriolar occlusion or anterior ischemic optic neuropathy was seen. As underlying risk factors we found diabetes mellitus (6 x) and systemic hypertension (3 x). After interruption (10 x) or dose reduction (2 x) of interferon therapy in all eyes the ischemic changes disappeared rapidly. Permanent visual loss or visual field defects remained in 3 out of 24 eyes.

Patients under interferon therapy should be monitored closely by an ophthalmologist, especially those with systemic vascular risk factors. In the case of development of ischemic microangiopathy of the retina or optic nerve, interferon therapy should be stopped or dose reduction is recommended.