Anterior ischemic optic neuropathy complicating interferon alpha and ribavirin therapy in patients with chronic hepatitisC

Retinal Changes In Patients with Hepatitis C Virus under treatment with interferon and ribavirin.

“…The age was statistically significant with a p value of 0.041 ( less than 0.05). This significance correlates with the conclusion of a previous study that mentioned the age as a risk factor of interferon retinopathy[16].A previous study reported that INF retinopathy can occur between the 4 th and 28 th weeks after initiation of treatment, more frequently within the first 16 weeks[17]. The incidence is possibly influenced by the frequency of fundus examination, because the subtle retinopathy may disappear after the long intervals between examinations.In our study the cotton wool spots developed in all the patients within the 12 th week and the 24 th week with an average of week 16 th .…”

Irreversible Anterior Ischemic Optic Neuropathy Complicating Interferon Alpha and Ribaverin Therapy

“…Lohmann and Coll hypothesized that interferon could produce autoantibodies, and thus cause desposition of immune complexes in the small retinal or optic cytokines causing an inflammatory reaction of the blood vessels that could then lead to ischemia [6]. The favorable course is uncommon in anterior ischemic optic neuropathy with vascular causes suggesting another mechanism [4]. The absence of resolution of anterior ischemic optic neuropathy after discontinuation of interferon in our patient suggests probable vascular causes.…”

“…The absence of resolution of anterior ischemic optic neuropathy after discontinuation of interferon in our patient suggests probable vascular causes. In the literature, the course of anterior ischemic optic neuropathy occurring during interferon treatment for chronic hepatitis C was favorable in four cases [7], and not resolved in three cases [2, 4]. After interruption of the antiviral treatment, our patient received methyl prednisolone, a steroid drug prescribed by the ophthalmologists, without favorable course of visual function.…”

“…Few cases have been reported in the literature [3] during antiviral treatment for chronic hepatitis C [2] and also during interferon treatment of cancer (2 cases), treatment of primary thrombocytemia (1 case), treatment of malignant melanoma (1 case), and during treatment of amyotrophic lateral sclerosis [4]. Predisposing factors have not been clearly identified, except for classic vascular risk factors (diabetes, arterial hypertension, and dyslipidemia) [2].…”

Vi-2 : Apport De l'ÉLECTROPHYSIOLOGIE Chez l'ADULTE : Exemples

“…Chez cette patiente où le traitement est envisagé pour encore 5 mois, une surveillance ophtalmologique très rapprochée doit être instaurée et la poursuite du traitement remise en question selon l'évolution des complications visuelles [Kirchhoff, et al, 2004], [Kabbaj et al, 2009]. …”