丙型肝炎与干扰素相关性视网膜病变：一例报告

Emory Eye Center, Atlanta, Georgia, USA.

Optometry. 2011 Dec;82(12):739-43. doi: 10.1016/j.optm.2010.11.016.

BACKGROUND

Hepatitis C is a common virus affecting approximately 170 million people worldwide. The main ocular manifestations of hepatitis C virus include a Sjögren-type of dry eye syndrome and an ischemic retinopathy secondary to treatment with interferon or a result of a systemic vasculitis induced by the infection itself. Current treatment for hepatitis C is a combination therapy using pegylated (long-lasting) interferon and ribavirin. This treatment, however, is not without ocular sequelae. Interferon-associated retinopathy is present in > 50% of patients taking the drug and is mainly characterized by cotton wool spots and retinal hemorrhages. The pathogenesis of this disorder is not specifically known. Fortunately, many patients remain asymptomatic, and the retinal changes are usually reversible.

CASE REPORT

A 48-year-old black man presented to the clinic complaining of decreased vision in both eyes for the previous few weeks. His medical history was positive for hypertension and hepatitis C for which he was being treated. At his examination, he had interferon retinopathy diagnosed. Soon thereafter, his treatment for hepatitis C was discontinued, and when he returned for follow-up 4 months later, his retinal findings had resolved.

CONCLUSIONS

An overview of hepatitis C and its recommended therapy and possible ocular side effects are reviewed, as well as the differential diagnosis of interferon-associated retinopathy, 1 of the main side effects of treatment.

背景

丙型肝炎是一种常见病毒，全球约有1.7亿人受其影响。丙型肝炎病毒的主要眼部表现包括干燥综合征样干眼综合征以及继发于干扰素治疗或感染本身所致系统性血管炎的缺血性视网膜病变。目前丙型肝炎的治疗是使用聚乙二醇化（长效）干扰素和利巴韦林的联合疗法。然而，这种治疗并非没有眼部后遗症。服用该药物的患者中超过50%存在干扰素相关性视网膜病变，其主要特征为棉絮斑和视网膜出血。这种疾病的发病机制尚不清楚。幸运的是，许多患者没有症状，视网膜改变通常是可逆的。