Del-Piñal Miguel, Klein-Burgos Claudia, Martín-Ucero Ana M, Larrañaga-Cores María, de la Hoz Adriana, López-Vázquez Ana, Fernández-Gutiérrez Eva
Department of Ophthalmology, Hospital Universitario La Paz, Madrid, Spain.
Department of Ophthalmology, Hospital Universitario de Torrejón, Madrid, Spain; and.
Cornea. 2023 May 1;42(5):648-650. doi: 10.1097/ICO.0000000000003254. Epub 2023 Feb 6.
To report a case of fibrinous acute anterior uveitis associated with topical interferon-α2b (IFN-α2b) treatment for ocular surface squamous neoplasia in a patient with HLA-B27 uveitis predisposition.
Case report.
We present the case of a 57-year-old man who received topical IFN-α2b as adjuvant therapy for a previously surgically removed ocular surface squamous neoplasia with affected surgical margins. Two weeks after topical IFN-α2b initiation, the patient was diagnosed with fibrinous acute anterior uveitis. Complementary tests to rule out other causes of uveitis resulted to be negative, except for HLA-B27, which tested positive. Response to treatment with topical corticosteroids and cyclopentolate was favorable. As IFN-α2b is considered an immune enhancer and has been widely associated with autoimmune side effects, topical therapy with IFN-α2b was temporally ceased until intraocular inflammation resolved. Topical IFN-α2b was resumed, and during follow-up, no signs of uveitis were detected. The main hypothesis is that IFN-α2b acts as a trigger for intraocular inflammation in individuals with uveitis predisposition.
Topical IFN-α2b could trigger intraocular inflammation in patients with uveitis susceptibility. It may be reasonable to use IFN-α2b cautiously in patients with a known history of uveitis or uveitis predisposition.
报告1例在1例有HLA - B27相关性葡萄膜炎易患倾向的患者中,局部应用干扰素 - α2b(IFN - α2b)治疗眼表鳞状细胞癌时发生纤维素性急性前葡萄膜炎的病例。
病例报告。
我们报告1例57岁男性患者,其因手术切除的眼表鳞状细胞癌切缘受累,接受局部IFN - α2b作为辅助治疗。在开始局部应用IFN - α2b两周后,该患者被诊断为纤维素性急性前葡萄膜炎。除HLA - B27检测呈阳性外,排除葡萄膜炎其他病因的补充检查结果均为阴性。局部应用皮质类固醇和环喷托酯治疗反应良好。由于IFN - α2b被认为是一种免疫增强剂,且与自身免疫性副作用广泛相关,因此暂时停用局部IFN - α2b治疗,直至眼内炎症消退。之后恢复局部应用IFN - α2b治疗,在随访期间未检测到葡萄膜炎迹象。主要假设是IFN - α2b在有葡萄膜炎易患倾向的个体中可引发眼内炎症。
局部应用IFN - α2b可能会在葡萄膜炎易感患者中引发眼内炎症。对于有葡萄膜炎病史或葡萄膜炎易患倾向的患者,谨慎使用IFN - α2b可能是合理的。