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Christoph M. Deuter, Deshka Doycheva, Ina Koetter, Manfred Zierhut; Long-term Results Of Treatment With Interferon Alpha For Chronic Uveitic Cystoid Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4262.
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To evaluate the long-term results in patients who have been treated with interferon alpha (IFN alpha) for chronic uveitic cystoid macular edema (CME).
To be eligible for analysis, patients had to suffer from chronic uveitic CME in at least one eye and had to complete a follow-up period of at least 24 months from start of IFN alpha (independend of how long IFN alpha was given). Treatment with IFN alpha-2a was started at an initial dose of 3-6 million IU per day subcutaneously for approximately four weeks. Afterwards, the dose of IFN alpha-2a was tapered stepwise to the lowest possible dose that keeps CME in remission, and was discontinued finally if possible.
Out of 58 patients, in whom we started with IFN alpha for chronic uveitic CME since 2003, 38 patients (14 male, 24 female; mean age 48.9 years, range 13-77 years) completed a follow-up of at least 24 months and thus were eligible for further analysis. Localisation of uveitis was anterior in 6, intermediate in 28, and posterior in 4 patients. IFN alpha was effective (complete and sustained resolution of CME) in at least one eye in 26 patients (68.4%), partly effective (reduction of CME) in 9 patients (23.7%), and not effective (no response or early relapse of CME) in 3 patients (7.9%). Mean follow-up period was calculated as 56.3 months (range 24-104 months). Mean duration of IFN alpha treatment was 47.2 months (range 1-100 months). During follow-up, 6 patients (15.8%) stopped IFN alpha treatment after 1-88 months due to inefficacy or side-effects. In 4 patients (10.5%), IFN alpha could be discontinued in remission of CME after 25-100 months; one patient relapsed after one month. In 28 patients (73.7%), treatment with IFN alpha was still ongoing at last visit in our hospital (duration of IFN alpha treatment 24-100 months).
IFN alpha is able to induce complete or partial resolution of chronic uveitic CME in a substantial proportion of affected patients. However, the majority of patients needs long-term treatment with IFN alpha to keep absence of CME.
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