Green Michael B, Butler Nicholas J
Department of Ophthalmology, Boston Medical Center, Boston, Massachusetts, USA.
Department of Ophthalmology, VA Boston Health Care System Jamaica Plain Campus, Boston, Massachusetts, USA.
Ocul Immunol Inflamm. 2025 Sep;33(7):1429-1435. doi: 10.1080/09273948.2024.2374439. Epub 2024 Jul 16.
To evaluate the efficacy of topical interferon alpha-2b (tIFN a2b) and subcutaneous pegylated interferon alpha-2a (peg-IFN a2a) in the treatment of refractory pseudophakic (PME) and uveitic (UME) macular edema.
Retrospective case series of patients with PME or UME that was non-responsive to conventional therapies. Topical IFN a2b drops (1 MIU/ml) were commenced four times a day. Non-responders were offered treatment with subcutaneous peg-IFN a2a starting at 180 mcg weekly.
Seven eyes of seven patients (three UME and four PME) were treated with tIFN a2b. Three eyes had complete ME resolution with tIFN treatment after a mean of 2.66 weeks (range 1-4 weeks) and no recurrence after a mean total course of 11.33 weeks (range 5-20 weeks). Two cases (both PME) had partial responses to tIFN treatment and two cases (both UME) failed to respond. Of the four eyes that incompletely responded to tIFN (treatment range 6 weeks to 4 months), three were treated with peg-IFN a2a, which invariably led to complete and sustained ME resolution. Adverse effects from topical treatment were mild and consisted mainly of superficial irritation. Adverse effects of subcutaneous treatment included nausea, vomiting, anorexia, and leukopenia, though none limited treatment.
Topical IFNa-2b appears safe and effective in isolation or in conjunction with topical steroids for the treatment of inflammatory macular edema (IME) in about half of patients in our small series. All partial and non-responders had complete disease resolution with systemic IFN. Topical IFN a2b should be considered in patients with refractory IME.
评估局部应用干扰素α-2b（tIFNα2b）和皮下注射聚乙二醇化干扰素α-2a（peg-IFNα2a）治疗难治性人工晶状体眼（PME）和葡萄膜炎性（UME）黄斑水肿的疗效。
对常规治疗无反应的PME或UME患者进行回顾性病例系列研究。开始每天4次使用浓度为1百万国际单位/毫升的tIFNα2b滴眼液。对无反应者给予皮下注射peg-IFNα2a治疗，起始剂量为每周180微克。
7例患者的7只眼（3例UME和4例PME）接受了tIFNα2b治疗。3只眼在平均2.66周（范围1 - 4周）的tIFN治疗后黄斑水肿完全消退，平均总疗程11.33周（范围5 - 20周）后无复发。2例（均为PME）对tIFN治疗有部分反应，2例（均为UME）无反应。在对tIFN反应不完全的4只眼中（治疗时间6周至4个月），3只眼接受了peg-IFNα2a治疗，均实现了黄斑水肿的完全且持续消退。局部治疗的不良反应轻微，主要为表面刺激。皮下治疗的不良反应包括恶心、呕吐、厌食和白细胞减少，但均未限制治疗。
在我们的小样本系列中，约一半患者单独使用局部IFNα-2b或与局部类固醇联合使用时，对于治疗炎症性黄斑水肿（IME）似乎是安全有效的。所有部分反应者和无反应者经全身应用干扰素后疾病均完全消退。对于难治性IME患者应考虑使用局部IFNα2b。
