Review
Copyright ©2013 Baishideng Publishing Group Co.
World J Gastroenterol. Dec 7, 2013; 19(45): 8227-8237
Published online Dec 7, 2013. doi: 10.3748/wjg.v19.i45.8227
Table 2 Incidence of interferon-associated retinopathy in observational studies during which more than half of the patients were treated with pegylated interferon-α based regimens for chronic hepatitis C
StudyIAR incidenceCountryTiming of examinationsComments
Mousa et al[27]8 of 98 (8%)EgyptBaseline, 2, 4, 8, 12 and 24 wk then every 3 moIAR: seven of 8 patients with IAR had no reduction in VA. No dose reduction for management of IAR. Combined DM and HTN gave relative risk of 6.5 of developing IAR. Atypical adverse events: vitreous hemorrhage from retinal tears with retinal detachment requiring vitrectomy in 1 patient, final visual outcomes were not described.
Fouad et al[28]22 of 84 (26%)EgyptBaseline, 12, 24 and 48 wk and 1 mo after completing treatmentIAR: no reduced VA in eyes that developed IAR. Three patients with IAR developed retinal hemorrhages and treatment was ceased. Logistic regression found HTN (9 of 12) and DM (13 of 16) to be predictors of developing IAR. Atypical adverse events: NAION in 2 patients and optic neuritis in 1 patient, final visual outcomes for these patients were not described.
Vujosevic et al[29]21 of 97 (22%)1CanadaBaseline, 3 and 6 mo and 3 mo after completing treatmentIAR: all patients with pre-existing retinopathy, 9 patients, had worsening of retinopathy during treatment. Factors associated with developing IAR were age, metabolic syndrome, HTN, cryoglobulinemia and pre-existing intraocular lesions. Using multivariate analysis only HTN was a significant predictor of developing IAR. Insufficient number of patients with DM (n = 5). Atypical adverse events: bilateral BRVO in one patient with a background of HTN resulting in irreversible vision loss in the left eye only.
Lim et al[30]5 of 10 (50%)2KoreaBaseline and then 3 weekly for 6 moIAR: no reduced VA in eyes that developed IAR. No dose reduction for management of IAR. Atypical adverse events: unilateral CRVO in 1 patient with a background of DM resulting in irreversible vision loss.
Mehta et al[31]18 of 64 (28%)3United StatesBaseline, 3 and 6 moIAR: no reduced VA in eyes that developed IAR. 1 of 88 ceased treatment for asymptomatic IAR. Male only cohort. HTN and DM not significant predictor of developing IAR. Poor follow up rates - 69% had an eye exam within the first 12 weeks of starting treatment. Atypical adverse events: nil reported.
Kim et al[32]11 of 32 (34%)KoreaBaseline, 4, 8, 12, 16, 24, 36 wkIAR: no reduced VA in eyes that developed IAR alone. No dose reduction for management of IAR. All retinal lesions spontaneously resolved. 91% of retinopathy developed within 2 mo, but 1 occurred at 4 mo. HTN significantly associated with development of IAR (6 of 10), T2DM not (1 of 2). Atypical adverse events: unilateral BRVO in 1 patient with background of HTN resulting in irreversible vision loss.
Panetta et al[33]7 of 183 (4%)United StatesBaseline and repeat examination when visually symptomaticIAR: three patients ceased treatment. Two with visual symptoms associated with IAR. 46% of patients had HTN and 16% had DM - neither predictive of developing IAR. Atypical adverse events: nil reported.
Malik et al[34]3 or 38 (8%)United KingdomBaseline, 3 and 6 mo. Low follow up ratesIAR: no reduced VA in eyes that developed IAR. No dose reduction for management of IAR. Atypical adverse events: nil reported.
Andrade et al[35]5 of 34 (15%)SpainBaseline, at cessation of treatment and when visually symptomaticIAR: no reduced VA in eyes that developed IAR. No dose reduction for management of IAR. Higher serum VEGF in patients with retinopathy and/or subconjunctival hemorrhage. Atypical adverse events: cystoid macular edema in 1 patient, final visual outcomes were not described.
Ogata et al[36]25 of 69 (36%)JapanBaseline and then regularly for 6 monthsIAR: no reduced VA in eyes that developed IAR. No dose reduction for management of IAR. 46% (13 of 28) treated with IFNα developed IAR compared to 29% (12 of 41) treated with PEG-IFNα. Atypical adverse events: no details.
Chisholm et al[37]5 of 10 (50%)United KingdomBaseline, 2, 4, 8, 12 and 24 wk and 12 wk after completing treatmentIAR: no dose reduction for management of IAR. Atypical adverse events: nil reported.
Cuthbertson et al[38]4 of 25 (16%)United Kingdom3 mo after starting treatment or when visually symptomaticIAR: no reduced VA in eyes that developed IAR. No dose reduction for management of IAR. Atypical adverse events: nil reported.

Citation: O’Day R, Gillies MC, Ahlenstiel G. Ophthalmologic complications of antiviral therapy in hepatitis C treatment. World J Gastroenterol 2013; 19(45): 8227-8237