Neurovisual impairment: A frequent complication of alpha‐interferon treatment in chronic viral hepatitis

摘要: Following our earlier observation of clinically evident optic tract neuropathy in patients receiving low-dose interferon (IFN) therapy, we prospectively evaluated 53 consecutive treated for chronic hepatitis B or C with a median dose 3 MU IFN-a 2b thrice weekly. Measurements included routine ophthalmologic evaluation and recordings visual evoked responses (VER), electroretinograms (ERG), acuity, fields, before, at the end IFN treatment, follow-up visits. Baseline P100 latencies VERs (base-VER) were abnormally prolonged 24 (32 106 eyes, 30.2%); age was only significant covariate associated increased risk an abnormal base-VER by multiple logistic regression (relative [RR] 5.3 per each 5-year increase age). In 45 (74 eyes) normal baseline latencies, end-of-treatment (end-VER) significantly compared baseline, becoming 11 (15 74 20.3%) (138.8 ± 8.7 vs. 117.7 5.2 ms, P <.001). This subgroup had older (59.1 11.0 47.5 15.3, =.007) reduced sensitivity their own pretreatment measurements (24.5 1.6 23.0 1.2db, =.019). Changes end-VERs sigmoid distribution steep values beyond 5 th decade (R 2 =.326, model, predictors were, patients' (RR 5.6 increase), presence virus (HBV) infection 15.1 [HCV] infection) serum cholesterol levels above 240 mg% 7.1 < mg%). Subconjunctival hemorrhages seen cases funduscopic examination revealed cotton wool spots one other. ERG amplitude remained unchanged. After stopping IFN, treatment-associated neurovisual abnormalities reversed to 7 (10 15 persisted (5 33.3%) up 37 (median 7.3) months observation, all remaining asymptomatic. conclusion, subclinical impairment is frequent, largely unrecognized complication appear be most susceptible. apparently innocuous long lasting, possibly irreversible some patients, yet undetermined consequences on function.