Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India.
Department of Vireo-Retina, Narayana Nethralaya, Bengaluru, Karnataka, India.
Indian J Ophthalmol. 2022 Dec;70(12):4357-4361. doi: 10.4103/ijo.IJO_1450_22.
To evaluate efficacy of topical interferon alfa-2b (IFN) in the treatment of uveitic macular edema (UME).
This is a prospective, interventional case study of patients with UME. Injection IFN was reconstituted into eye drops and a four times/day (QID) application was prescribed. Central macular thickness (CMT) on optical coherence tomography (OCT) scan was evaluated. Improvement in CMT by ≥50 μm from the baseline was studied in eyes with presenting CMT ≥400 μm.
Twenty eyes of 20 patients with UME were studied: anterior uveitis (n = 3), anterior + intermediate uveitis (n = 5), posterior uveitis (n = 3), retinal vasculitis (n = 3), and panuveitis (n = 6). Mean CMT at the presentation was 423.3 μm (range: 270-604 μm), which improved at 1 month (n = 16), 2 months (n = 10), and ≥3 months (n = 11) follow-up, to 415.3 μm (range: 247-579 μm) (P = 0.411), 364.4 μm (range: 258-566 μm) (P = 0.099), 344 μm (range: 258-484 μm) (P = 0.001), respectively. Twelve eyes of 12 patients had presenting CMT ≥400 μm. In these cases, decrease in CMT by ≥50 μm was seen in 4/10, 4/5, and 5/6 eyes at 1 and 2 months and ≥3 months follow-up. Mean follow-up was 4 months (range: 1-17 months). Complete resolution of UME was seen only in three eyes. No ocular or systemic side effects were observed.
Topical IFN therapy in QID doses is safe but may have limited role in UME. Long-term therapy may improve its efficacy. Larger studies with dose modification, combination with other drugs, and with homogeneous uveitis population are recommended.
评估局部应用干扰素 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 患者的前瞻性、干预性病例研究。将 IFN 注射液重新配制为滴眼液，并规定每天应用 4 次（QID）。通过光学相干断层扫描（OCT）评估中央黄斑厚度（CMT）。对基线时 CMT≥400μm的患者，研究 CMT 较基线改善≥50μm的情况。
20 例 20 只眼患有 UME：前部葡萄膜炎（n=3）、前+中间葡萄膜炎（n=5）、后部葡萄膜炎（n=3）、视网膜血管炎（n=3）和全葡萄膜炎（n=6）。初次就诊时的平均 CMT 为 423.3μm（范围：270-604μm），1 个月（n=16）、2 个月（n=10）和≥3 个月（n=11）随访时分别改善至 415.3μm（范围：247-579μm）（P=0.411）、364.4μm（范围：258-566μm）（P=0.099）、344μm（范围：258-484μm）（P=0.001）。12 只眼中有 12 只的初始 CMT≥400μm。在这些病例中，1 和 2 个月及≥3 个月随访时，CMT 下降≥50μm的分别有 4/10、4/5 和 5/6 只眼。平均随访时间为 4 个月（范围：1-17 个月）。仅 3 只眼完全缓解 UME。未观察到眼部或全身副作用。
QID 剂量的局部 IFN 治疗安全，但在 UME 中的作用可能有限。长期治疗可能会提高其疗效。建议进行更大规模的研究，包括剂量调整、与其他药物联合应用以及针对同质葡萄膜炎人群。
