Paire V, Lebreton O, Weber M
Service d'ophtalmologie, Hôtel Dieu - CHU de Nantes, Nantes.
J Fr Ophtalmol. 2010 Mar;33(3):152-62. doi: 10.1016/j.jfo.2010.01.008. Epub 2010 Feb 24.
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.
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.
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.
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.
黄斑水肿一直是中间葡萄膜炎和/或后葡萄膜炎的主要并发症。其中一些黄斑水肿对类固醇和/或免疫抑制药物无效。干扰素是一种已被证实可治疗白塞病的药物，具有抗增殖和免疫调节特性，这对于对类固醇和/或免疫抑制剂无效的葡萄膜炎性水肿可能非常有价值。最近的研究通过证明其在受影响患者中的低血药浓度，揭示了α-干扰素的价值。
我们描述了一系列连续6例葡萄膜炎性黄斑水肿，其中2例继发于鸟枪弹样视网膜脉络膜病变，4例特发性葡萄膜炎患者接受了α-干扰素治疗。我们的小病例系列显示，黄斑区测量值减少了189.7±67μm，视力提高了0.35±0.21 LogMAR。
其他文献表明，在治疗不到1个月时，黄斑水肿和视力就有显著改善。我们的小病例系列也得到了与其他研究相同的结果，尽管治疗方案的激进程度较低。然而，我们也观察到了一些众所周知的副作用，尤其是抑郁。
在我们连续6例对类固醇或免疫抑制药物无效的葡萄膜炎性黄斑水肿病例系列中，α-干扰素产生了非常有利的解剖学和功能结果。必须明确治疗方式，但似乎较短的疗程和较低的剂量可能同样有效，并且与目前文献中提出的方案相比，并发症发生率更低。
