Tropical Medicine Department, Mansoura University, Mansoura, Egypt.
J Ocul Pharmacol Ther. 2013 Apr;29(3):345-8. doi: 10.1089/jop.2012.0169. Epub 2012 Oct 31.
Many side effects of combination therapy using pegylated interferon (IFN) and ribavirin for treatment of chronic hepatitis C virus (HCV) infection have been well described. Ocular complications are fairly common. Diabetes mellitus (DM) and systemic hypertension are possible suggested risk factors for development of these complications.
To determine the frequency of retinopathy and its risk factors in patients treated with combined pegylated IFN and ribavirin for chronic hepatitis C infection.
Eligible 98 patients for HCV treatment with pegylated IFN a-2a, a-2b, and ribavirin between October 2011 and March 2012 were included. All patients underwent a baseline full ophthalmological examination, and any visual complaints during treatment prompted a repeat eye examination.
Out of the eligible 98 patients, 48 (48.78%) patients received pegylated IFN alpha-2a, and the other 50 (51.21%) patients were treated with pegylated IFN alpha-2b. Out of 98 patients, 21 (21.42%) had diabetes; 19 (19.38%) patients had hypertension and 16 (16.32%) patients had both diabetes; and hypertension. Only 8 patients (8.16%) had documented retinopathy [2 had DM; one had hypertension; 4 had both hypertension and diabetes; and one patient without DM or hypertension]. Univariate logistic regression analysis revealed that diabetic, hypertensive patients are at increased risk for development of IFN-associated retinopathy (IAR) (P=0.007, Odds ratio=6.5, 95% confidence interval=1.56-27.
Retinopathy in chronic HCV-infected patients undergoing treatment with combination of pegylated IFN-alpha and ribavirin therapy appears to be relatively low, and treatment cessation is rarely needed. Diabetic, hypertensive patients are at increased risk for IAR and are recommended to be ophthalmologically followed-up.
聚乙二醇干扰素（IFN）联合利巴韦林治疗慢性丙型肝炎病毒（HCV）感染的联合治疗有许多副作用已得到很好的描述。眼部并发症相当常见。糖尿病（DM）和系统性高血压可能是这些并发症发生的潜在危险因素。
确定接受聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎感染的患者中视网膜病变的发生率及其危险因素。
纳入 2011 年 10 月至 2012 年 3 月期间接受聚乙二醇干扰素 a-2a、a-2b 和利巴韦林治疗的 98 例 HCV 治疗合格患者。所有患者均接受基线全面眼科检查，治疗期间出现任何视力问题均需重复眼部检查。
在 98 例合格患者中，48 例（48.78%）患者接受聚乙二醇干扰素α-2a 治疗，50 例（51.21%）患者接受聚乙二醇干扰素α-2b 治疗。98 例患者中，21 例（21.42%）患有糖尿病；19 例（19.38%）患者患有高血压，16 例（16.32%）患者同时患有糖尿病和高血压。仅有 8 例（8.16%）患者有明确的视网膜病变[2 例患有糖尿病；1 例患有高血压；4 例同时患有高血压和糖尿病；1 例患者无糖尿病或高血压]。单变量逻辑回归分析显示，糖尿病、高血压患者发生 IFN 相关视网膜病变（IAR）的风险增加（P=0.007，优势比=6.5，95%置信区间=1.56-27.
接受聚乙二醇干扰素-α联合利巴韦林治疗的慢性 HCV 感染患者的视网膜病变似乎相对较低，很少需要停止治疗。糖尿病、高血压患者发生 IAR 的风险增加，建议进行眼科随访。
