[Effectiveness of interferon alpha in the treatment of uveitis macular edema refractory to corticosteroid and/or immunosuppressive treatment]

J Fr Ophtalmol. 2010 Mar;33(3):152-62. doi: 10.1016/j.jfo.2010.01.008. Epub 2010 Feb 24.
[Article in French]

Abstract

Introduction: Macular edema is always a major complication in intermediate and/or posterior uveitis. Some of these macular edemas are refractory to steroid and/or immunosuppressive drugs. Interferon, a validated treatment for Behçet disease, has antiproliferative and immunoregulative properties that may be very valuable in uveitic edema refractory to steroid and/or immunosuppressive agents. Recent studies have brought out the value of interferon-alpha by demonstrating its low blood rate in affected patients.

Observations: We describe a series of six consecutive uveitic macular edema, secondary to two birdshot retinochoroidopathy, and four cases of idiopathic uveitis treated with interferon-alpha. Our small case series showed a 189.7+/-67 mum decrease in mapping and an improvement in visual acuity of 0.35+/-0.21 LogMAR.

Discussion: Other publications have shown a remarkable efficacy on macular edema and visual acuity in less than 1 month of treatment. Our small case series found the same results as the other studies, despite a less aggressive therapeutic regimen. However, we also observed some well-known side effects, in particular depression.

Conclusion: In our series of six consecutive cases of uveitic macular edema refractory to steroid or immunosuppressive drugs, alpha-interferon provided highly advantageous anatomical and functional results. The treatment modality must be specified, but it seems that a shorter duration and lower posologies might be as effective and lead to a lower rate of complications than the regimen currently proposed in the literature.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Chorioretinitis / complications
  • Drug Resistance
  • Female
  • Glaucoma / complications
  • Glaucoma / surgery
  • Humans
  • Immunologic Factors / therapeutic use*
  • Immunosuppressive Agents / therapeutic use
  • Interferon-alpha / therapeutic use*
  • Macular Edema / drug therapy*
  • Male
  • Middle Aged
  • Recurrence
  • Uveitis, Intermediate / complications*
  • Uveitis, Posterior / complications*
  • Visual Acuity
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Immunologic Factors
  • Immunosuppressive Agents
  • Interferon-alpha