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Egbert Matthe, Dirk Sandner, Lutz E Pillunat; Systemic Interferon alpha 2a for treatment of chronic relapsing Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6384.
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Interferons are used systemically for therapy of chronic hepatitis, some forms of cancer and locally for conjunctival melanocyte disorders. They act highly antiexsudative. Central serous chorioretinopathy (CSC) is caused by exsudation from choroidal vessels resulting in detachment of the retinal pigment epithelium or neurosensory retina. We examined the use of systemic interferon alpha 2a for the treatment of chronic relapsing CSC (CRCSC).
Evaluation of data and history of 6 patients with CRCSC who did not respond to (diuretics, aspirin, anti-VEGF intravitreally), could not receive (photocoagulation), or did not wish common treatment (photodynamic therapy, anti-VEGF intravitreally). Duration of CSC was at least 12 month with at least 1 recurrence. Each patient was treated with 3 million International Units of Interferon alpha 2a daily for 4 weeks, and 2 more weeks given the medication every other day. Visual acuity and central foveal thickness measured with spectral domain OCT were obtained. The patients graded the side effects as “none”, “mild” (notable but not irritating), “tolerable” (irritating, but willing to continue because of efficacy) and “not tolerable”, which stopped treatment.
All patients had reduction of subretinal and sub-pigment-epithelial fluid, with complete resorption in 4 cases. Depending on the duration of the CSC, visual acuity increased up to four Snellen lines. 2 patients had very small amounts of fluid when treatment was stopped. 2 patients had recurrence of fluid, one of them twice. We saw recurrence after 2 month and 4 month for the 1st patient, and after 4 month for the 2nd. Re-treatment was effective for all recurrences (gain of visual acuity up to 4 Snellen lines). Side effects were graded as “none” by 1 patient, “mild” by 3 patients (flu-like, fatigue), which could be overcome by adding Paracetamol, “tolerable” by 2 patients (obstipation, dizziness, nausea). Only 1 patient we had to grade the side effects as “not tolerable” (leucopenia).
We present the first case series of systemic Interferon alpha 2a for treating CRCSC. It provides excellent short term results in reducing subretinal and sub-pigment-epithelial fluid in CRCSC. Treatment is repeatable if necessary. Patients have to be examined for side effects, which might require the therapy to be stopped.
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