Moisseiev Elad, Goldenberg Dafna, Kurtz Shimon
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Ophthalmic Surg Lasers Imaging. 2011 Sep 8;42 Online:e91-3. doi: 10.3928/15428877-20110901-07.
Retinopathy associated with pegylated interferon and ribavirin is a known complication of this therapy, and is typically bilateral and asymptomatic. Few patients complain of visual disturbance, and only rarely is there permanent visual impairment after the retinopathy resolves. A 65-year-old man presented with bilateral reduced visual acuity. Treatment with pegylated interferon and ribavirin was initiated 12 weeks prior due to chronic hepatitis virus C. On examination, multiple cotton-wool spots were noticed bilaterally, and visual field testing demonstrated decreased sensitivity. Treatment was stopped and the retinopathy was followed up for 4 months by ophthalmic examination and high-resolution optical coherence tomography. The cotton-wool spots resolved and high-resolution optical coherence tomography demonstrated restoration of normal retinal configuration. Visual acuity and visual field testing improved over 4 months, but did not return to their baseline values. This is a rare case of permanent visual impairment caused by retinopathy associated with pegylated interferon and ribavirin.
聚乙二醇化干扰素和利巴韦林相关的视网膜病变是这种治疗方法已知的并发症，通常为双侧且无症状。很少有患者抱怨视力障碍，视网膜病变消退后仅有极少数患者会出现永久性视力损害。一名65岁男性因双侧视力下降就诊。由于慢性丙型肝炎，12周前开始使用聚乙二醇化干扰素和利巴韦林治疗。检查时，双侧均发现多个棉絮斑，视野检查显示敏感度降低。停止治疗，并通过眼科检查和高分辨率光学相干断层扫描对视网膜病变进行了4个月的随访。棉絮斑消退，高分辨率光学相干断层扫描显示视网膜结构恢复正常。视力和视野检查在4个月内有所改善，但未恢复到基线值。这是一例由聚乙二醇化干扰素和利巴韦林相关的视网膜病变导致永久性视力损害的罕见病例。
