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多发性硬化症患者接受β-干扰素治疗期间的视网膜病变:病例报告及文献综述

Retinopathy during interferon-β treatment for multiple sclerosis: case report and review of the literature.

作者信息

Gaetani Lorenzo, Menduno Paola S, Cometa Francesco, Di Gregorio Maria, Sarchielli Paola, Cagini Carlo, Calabresi Paolo, Di Filippo Massimiliano

机构信息

Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia, 06132, Perugia, Italy.

Clinica Oculistica, Dipartimento di Scienze Chirurgiche e Biomediche, Università degli Studi di Perugia, Perugia, Italy.

出版信息

J Neurol. 2016 Mar;263(3):422-7. doi: 10.1007/s00415-015-7879-0. Epub 2015 Aug 21.

Abstract

The onset of new visual symptoms in patients with multiple sclerosis is often associated with a neuro-ophthalmologic manifestation of the disease. However, other possible differential diagnoses need to be ruled out, including drug-induced retinal side effects. Although uncommon, retinal side effects of interferon-beta formulations may occur, and need to be promptly recognized and treated by neurologists. In this manuscript, we report the case of a 37-year-old woman affected by multiple sclerosis diagnosed with interferon beta-associated retinopathy and we review the literature with regard to the epidemiology, clinical presentation, management and follow-up of interferon beta-associated retinopathy. Interferon-beta induced retinopathy seems to be an uncommon and a dose-related side effect in multiple sclerosis patients. Retinopathy tends to completely resolve after treatment discontinuation. Neurologists must be aware that immune-modulatory drugs, in particular interferon beta, have been reported to cause retinal side effects. In multiple sclerosis patients complaining of new visual symptoms during interferon-beta treatment, it is thus advisable to perform an ophthalmological assessment to rule out and properly manage retinopathy.

摘要

多发性硬化症患者出现新的视觉症状通常与该疾病的神经眼科表现相关。然而,其他可能的鉴别诊断也需要排除,包括药物引起的视网膜副作用。虽然罕见,但干扰素-β制剂的视网膜副作用可能会发生,神经科医生需要及时识别并进行治疗。在本手稿中,我们报告了一名37岁患有多发性硬化症的女性被诊断为干扰素β相关性视网膜病变的病例,并回顾了关于干扰素β相关性视网膜病变的流行病学、临床表现、管理和随访的文献。干扰素-β诱导的视网膜病变在多发性硬化症患者中似乎是一种罕见的、与剂量相关的副作用。视网膜病变在停药后往往会完全缓解。神经科医生必须意识到,据报道免疫调节药物,特别是干扰素β,会引起视网膜副作用。因此,在接受干扰素-β治疗期间出现新视觉症状的多发性硬化症患者中,建议进行眼科评估以排除并妥善管理视网膜病变。

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