Download Interferon Retinopathy

Interferon Retinopathy
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Uses of interferon:
1. Chronic HCV
2. Leukemia, lymphoma
3. Tumors e.g. Kaposi sarcoma, renal cell carcinoma, cutaneous melanoma, hemangiomas
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Effect:
1. Anti-viral
2. Anti-tumor
3. Anti-fibrotic
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Systemic side effects:
1. Influenza-like syndrome consisting of fever, chills, myalgias, arthralgias, and headache.
2. Fatigue has been the most prevalent chronic toxicity.
3. Toxicities of the CNS, haematopoietic system, GIT, renal function, skin, CVS, musculoskeletal system, and
endocrine system
Retinopathy:
» Pathogenesis:
1. Immune complex deposition
2. Ischemic insult
» Risk factors:
1. DM
2. HTN
3. Anemia, ↑ lipid, cholesterol
» Toxic dose:
Not well defined; 9 × 10 6 U/day, six times/week
» Time of appearance:
Variable 2 weeks – 3 months from onset of treatment
» Clinical picture:
Typical retinopathy
Atypical retinopathy
» Retinal hemorrhage
» Retinal hemorrhage
» CWS
» CWS
» CMO
» ONH swelling
» RVO
VA is not affected
VA is affected
Resolve spontaneously or after stoppage of drug
May not resolve after stoppage of drug
» Screening:
Patients should be examined before starting interferon to look for pre-existing retinopathy.
 If any is present  interferon should not be used or the patient should be monitored closely—for
example, monthly.
 If no retinopathy is present  less frequent examinations might be performed, such as at 3
months, unless the patient notes decreased vision.
 If severe ocular toxicity occurs  interferon therapy should be discontinued.