No abstract

No abstract

LETTERS 513 (Fig. 1c). Although she received urokinase and hyperbaric oxygen treatment, her right BCVA remains 0.1.A 61-year-old woman developed blurred vision in the right eye after 6 months of treatment with pegylated interferon-α and ribavirin. Ophthalmologic evaluation revealed scattered or fl ame-shaped retinal hemorrhage (Fig. 2). Since she had never undergone ophthalmologic examination, information regarding her previous retinal status was unavailable. Her BCVA was 0.1 (OD), which recovered to 1.2 (OD) after treatment with urokinase and hyperbaric oxygen. CommentsInterferon-associated retinopathy, a microcirculatory disorder of the retina characterized by soft exudates and retinal hemorrhages, was fi rst described by Ikebe et al. in 1990. 3 Reported risk factors for interferon retinopathy include hypertension, diabetes mellitus, high interferon dosages, ribavirin, and pegylated interferon. 4 Both hypertension and diabetes disrupt retinal microcirculation. Han et al. 5 report a case of symptomatic interferon-associated retinopathy successfully treated by hypertension management without stopping interferon administration. Even if interferon-associated retinopathy is observed during ophthalmologic monitoring, it may be diffi cult to discontinue the treatment with interferon-α and ribavirin given their excellent effects in the treatment of hepatitis C. However, as the present cases demonstrate, interferon-associated retinopathy can lead to vision-threatening diseases such as CRVO.When administration of interferon is continued for the treatment of chronic hepatitis C, management of systemic complications that affect retinal circulation, such as diabetes mellitus and hypertension, should be optimized. Even if the retinopathy appears to be completely resolved, retinal changes should be closely monitored since resolution of soft exudates does not guarantee the amelioration of the interferon-associated retinopathy.

Hypertrophic pachymeningitis is a condition with a wide spectrum of etiologies and clinical manifestations, and needs to be considered as the cause in patients with alterations in ocular motility