[Effectiveness of interferon alpha in the treatment of uveitis macular edema refractory to corticosteroid and/or immunosuppressive treatment].

INTRODUCTION

Macular edema is always a major complication in intermediate and/or posterior uveitis. Some of these macular edemas are refractory to steroid and/or immunosuppressive drugs. Interferon, a validated treatment for Behçet disease, has antiproliferative and immunoregulative properties that may be very valuable in uveitic edema refractory to steroid and/or immunosuppressive agents. Recent studies have brought out the value of interferon-alpha by demonstrating its low blood rate in affected patients.

OBSERVATIONS

We describe a series of six consecutive uveitic macular edema, secondary to two birdshot retinochoroidopathy, and four cases of idiopathic uveitis treated with interferon-alpha. Our small case series showed a 189.7+/-67 mum decrease in mapping and an improvement in visual acuity of 0.35+/-0.21 LogMAR.

DISCUSSION

Other publications have shown a remarkable efficacy on macular edema and visual acuity in less than 1 month of treatment. Our small case series found the same results as the other studies, despite a less aggressive therapeutic regimen. However, we also observed some well-known side effects, in particular depression.

CONCLUSION

In our series of six consecutive cases of uveitic macular edema refractory to steroid or immunosuppressive drugs, alpha-interferon provided highly advantageous anatomical and functional results. The treatment modality must be specified, but it seems that a shorter duration and lower posologies might be as effective and lead to a lower rate of complications than the regimen currently proposed in the literature.