Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India.
Department of Retina, Narayana Nethralaya, Bangalore, Karnataka, India.
Indian J Ophthalmol. 2022 Aug;70(8):2986-2989. doi: 10.4103/ijo.IJO_3210_21.
To evaluate the efficacy of intensive topical interferon alfa-2b (IFN) therapy in uveitic macular edema (UME).
This is a prospective, interventional case study of eyes with UME. Commercially available injection IFN for subcutaneous use was reconstituted to form eye drops and a dose of 6 times/day for 2 weeks, 5 times/day for next 2 weeks, followed by 4, 3, 2, 1 taper per month was prescribed. Optical coherence tomography (OCT) and clinical examination was done at 0, 2, 4, 8 weeks, and further as required.
Nine eyes of 9 patients with UME were studied. Mean central macular thickness (CMT) at presentation was 522.2 μm (range: 408-803 μm). At 2-week, 1-month, and 2-month follow-up, mean CMT decreased to 451.6 μm (range: 322-524 μm), 375.8 μm (range: 287-480 μm), and 360.3 μm (range: 260-485 μm), respectively. Four eyes which showed inadequate response to previous topical IFN therapy (4 times/day) showed significant improvement with intensive therapy at 1 month follow-up. In 4 eyes, UME resolved completely with mean CMT 285.5 μm (range: 260-312 μm) at 7.5 weeks (range: 4-12 weeks). Study exit was seen in 2 cases due to inadequate response and relapse of uveitis. Mean follow up was 3.38 months (range: 1-5 months).
Intensive topical IFN therapy can be an alternative therapeutic option in the treatment of UME. Study of intraocular penetration, combination with other drugs, and the efficacy of IFN separately for different uveitic entities may explore new avenues in treatment of UME.
评估强化局部干扰素 alfa-2b（IFN）治疗葡萄膜炎性黄斑水肿（UME）的疗效。
这是一项针对 UME 眼的前瞻性、干预性病例研究。将市售的用于皮下注射的 IFN 重新配制为滴眼剂，剂量为每天 6 次，持续 2 周，然后每天 5 次，再持续 2 周，随后每月递减 1 次，每次减少 1 滴。在 0、2、4、8 周时进行光学相干断层扫描（OCT）和临床检查，并根据需要进一步检查。
9 名患者的 9 只眼纳入研究。UME 患者的平均中央黄斑厚度（CMT）为 522.2μm（范围：408-803μm）。在 2 周、1 个月和 2 个月随访时，平均 CMT 分别降至 451.6μm（范围：322-524μm）、375.8μm（范围：287-480μm）和 360.3μm（范围：260-485μm）。4 只眼先前接受每日 4 次局部 IFN 治疗反应不足，在 1 个月随访时强化治疗后显著改善。在 4 只眼中，UME 完全消退，平均 CMT 为 285.5μm（范围：260-312μm），在 7.5 周（范围：4-12 周）时达到。由于治疗反应不足和葡萄膜炎复发，2 例患者退出研究。平均随访时间为 3.38 个月（范围：1-5 个月）。
强化局部 IFN 治疗可能是 UME 治疗的一种替代治疗选择。研究眼内渗透、与其他药物联合使用以及 IFN 分别对不同葡萄膜炎实体的疗效，可能为 UME 的治疗探索新途径。
