INTERFERON RELATED OPHTHALMIC COMPLICATIONS IN PATIENTS OF HEPATITIS C

Ophthalmic Complications

Abstract

Objectives: To determine the frequency of ophthalmic complications of interferon-α 2b and ribavirin combination therapy in patients of chronic hepatitis C.
Study Design: Quasi experimental study.
Place and Duration of the Study: Eye and Medical Department of Military Hospital Rawalpindi and Combined Military Hospital Peshawar, Pakistan from Jan 2010 to Jan 2011.
Patients and Methods: A total of 93 diagnosed and consenting cases of hepatitis C were recruited who were eligible for interferon therapy. They were administered 3 million units (mu) interferon (INF)-α 2b, subcutaneously thrice a week along with 800 mg of ribavirin orally daily for 6 months. Ocular examination of all the patients was performed before starting interferon and then monthly afterwards till the completion of interferon therapy. Their ocular complications were observed and recorded.
Results: The study included 54 (58%) males and 39 (42%) females. Mean age of the patients was 40.59 ± 8.68 years. Ocular complications developed in 24 (25.8%) out of 93 patients. Retinal microaneurysms were present in 5 (5.4%), cotton wool spots in 10 (10.8%), retinal haemorrhages in 8 (8.6%) and optic disc hyperaemia in 1 (1.1%) patient. These complications developed within 8-12 weeks after start of INF therapy.
Conclusion: Interferon alpha-2b and ribavirin combination therapy is characterized by its ophthalmic complications which are usually benign and self limiting. In our study, ocular complications which include retinal microaneurysms, cotton wool spots, retinal haemorrhages and optic disc hyperaemia developed in 25.8% of patients. In two third of these cases, these complications resolved before completion of INF therapy.