Case 341

Area of Science:

• Neurology
• Immunology
• Ophthalmology

Background:

• Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• Interferon-beta (IFN-β) is a common disease-modifying therapy for relapsing MS.
• Treatment monitoring is crucial to identify potential adverse effects.

Purpose of the Study:

• To report a case of blurry vision in a multiple sclerosis patient on interferon-β therapy.
• To investigate the potential causes of visual disturbances and other symptoms.
• To evaluate the safety profile of interferon-β in long-term MS management.

Main Methods:

• Case report of a 36-year-old male with relapsing multiple sclerosis.
• Clinical presentation including blurry vision and severe hypertension.
• Diagnostic workup involving MRI, fundoscopy, and laboratory tests (liver enzymes, urine albumin-to-creatinine ratio, lipid profile, CSF analysis).

Main Results:

• The patient presented with blurry vision, significantly elevated blood pressure (214/122 mm Hg), and hypertensive retinopathy.
• Laboratory findings showed elevated liver enzymes, microalbuminuria, and hyperlipidemia, consistent with interferon-β side effects.
• Cerebrospinal fluid analysis was positive for oligoclonal bands, confirming MS activity, but negative for infections.

Conclusions:

• Blurry vision in this MS patient was attributed to interferon-β treatment-induced hypertensive retinopathy and elevated liver enzymes.
• Close monitoring for adverse effects, including hypertension and liver function, is essential during interferon-β therapy for multiple sclerosis.
• A wait-and-see approach was adopted, managing hypertension without steroids or antimicrobials.