Plskova Jarka, Greiner Kathrin, Forrester John V
Department of Ophthalmology, University of Aberdeen, Aberdeen, Scotland, United Kingdom.
Am J Ophthalmol. 2007 Jul;144(1):55-61. doi: 10.1016/j.ajo.2007.03.050.
Several studies have shown the capacity of interferon-alpha (IFN-alpha) to control ocular Behçet disease. The authors aimed to determine whether IFN-alpha was effective in treating patients with severe, refractory sight-threatening intraocular inflammation (uveitis) from a wider range of causes, including Behçet disease.
Prospective, interventional case series.
Twelve patients with sight-threatening uveitis that failed to respond to one or more immunosuppressive regimens were enrolled to this study. Recombinant human IFN-alpha-2b was administered subcutaneously daily, and the dose was adjusted according to the clinical response. Main outcome measures were visual acuity, clinical activity of uveitis (including binocular indirect ophthalmoscopy [BIO] score and presence or absence of macular edema), and adverse effects of the treatment.
The mean observation period was 11 months (range, one to 29 months). A positive clinical response was observed in 83% of patients. Median visual acuity improved from 0.54 to 0.2 (logarithm of the minimum angle of resolution units; P < .001) and median BIO score decreased from 1.0 to 0.5 (P < .05) within one month of treatment. Macular edema, if present, resolved in all patients within days of treatment. The main adverse events were tiredness, lymphopenia, flu-like symptoms, and transient increase of liver enzymes. Weight loss occurred in four patients. Four patients experienced depression, one of them attempting suicide. Three patients experienced typical features of IFN-alpha-associated retinopathy, which resolved on reducing the dose.
IFN-alpha seems to have significant potential in treatment of severe, sight-threatening refractory uveitis from a variety of causes. A range of adverse events, including IFN-alpha-associated retinopathy, may occur and could limit the use of this immunomodulatory drug.
多项研究已表明α干扰素（IFN-α）控制眼部白塞病的能力。作者旨在确定IFN-α对于治疗因包括白塞病在内的更广泛病因导致的严重、难治性威胁视力的眼内炎症（葡萄膜炎）患者是否有效。
前瞻性干预性病例系列研究。
12例对一种或多种免疫抑制方案无反应的威胁视力的葡萄膜炎患者纳入本研究。重组人IFN-α-2b每日皮下注射，剂量根据临床反应进行调整。主要观察指标为视力、葡萄膜炎的临床活动度（包括双眼间接检眼镜检查[BIO]评分及黄斑水肿的有无）以及治疗的不良反应。
平均观察期为11个月（范围1至29个月）。83%的患者观察到临床阳性反应。治疗1个月内，中位视力从0.54提高至0.2（最小分辨角对数单位；P <.001），中位BIO评分从1.0降至0.5（P <.05）。黄斑水肿若存在，在治疗数天内所有患者均消退。主要不良事件为疲劳、淋巴细胞减少、流感样症状及肝酶短暂升高。4例患者出现体重减轻。4例患者出现抑郁，其中1例企图自杀。3例患者出现IFN-α相关视网膜病变的典型特征，减少剂量后病变消退。
IFN-α似乎在治疗各种病因导致的严重、威胁视力的难治性葡萄膜炎方面具有显著潜力。可能会出现一系列不良事件，包括IFN-α相关视网膜病变，这可能会限制这种免疫调节药物的使用。
