[Treatment of age-associated macular degeneration with interferon-alfa-2a]

Laser treatment of subfoveal neovascular membranes secondary to age-related macular degeneration (AMD) has been proven to be beneficial with regard to long-term contrast sensitivity and central scotoma size, but significant visual loss occurs immediately after treatment and it is therefore not generally accepted. Alternative treatment modalities should be evaluated. The observation made by Dr. W. Fung that patients with subretinal neovascular membranes may benefit from systemic treatment with the angiogenesis inhibitor interferon alpha-2a has stimulated much interest in this new treatment modality. We present four patients suffering from a subfoveal neovascular membrane who have been treated with this drug. In three cases the membrane was of an occult type, in one case there was a combination of classic and occult choroidal neovascularization. In all patients there had been progressive visual loss during the last 6 months prior to treatment. Visual acuity stabilized in three cases with occult neovascularization. In one case with classic choroidal neovascularization the membrane increased in size during treatment and a further drop of visual acuity was noted. Despite the fact that serious side effects could not be observed in our patients, the results do not allow to recommend Interferon for widespread use in the treatment of subretinal neovascular membranes, especially because the number of patients was small and the follow up time short. Its efficacy needs to be demonstrated by randomized clinical trials.