Abstract
Purpose :
Interferon alpha (IFN) has been demonstrated to be an effective treatment in patients with chronic uveitic macular edema (ME) refractory to conventional medications. However, few information is available about the long-term results of this therapy. Therefore, we wanted to evaluate which proportion of patients was able to stop IFN in remission of ME and how many of these patients subsequently remained relapse-free.
Methods :
We present a retrospective analysis of an interventional case series. We included all patients who started a treatment with subcutaneous IFN (initial dose: 3-6 mio. IU per day) for chronic uveitic ME (unilateral or bilateral) at least two years before November 2017 (deadline for analysis). Follow-up was defined as the period from start of IFN until the last visit in our uveitis service.
Results :
In a first analysis, 82 patients with chronic ME due to anterior (n=13; 15,9%), intermediate (n=50; 61.0%), posterior (n=16; 19.5%), or panuveitis (n=3; 3.7%) were eligible for analysis. Gender was male in 33 patients (40.2%) and female in 49 patients (59.8%). Mean age was 48.4 years (SD 16.3 years; range 13 to 77 years). Mean values were 85.2 months (SD 40.9 months; range 24 to 176 months) for follow-up and 53.6 months (SD 40.7 months; range 2 to 151 months) for duration of IFN treatment. At the end of follow-up, IFN treatment was ongoing in 38 patients (46.3%). In 19 patients (23.2%), treatment had to be discontinued prematurely due to inefficacy or due to side effects. In 25 patients (30.5%), IFN treatment could be discontinued in remission of ME after a mean treatment duration of 36.6 months (SD 38.2 months; range 2 to 141 months). Of these, 16 patients (64.0%) developed a relapse of ME after a mean interval of 9.3 months (SD 14.9 months; range 0 to 58 months). In the remaining 9 patients (36.0%) there was no recurrence of ME in the period between discontinuation of IFN and the last visit, which was on average 46.9 months (SD 41.9 months; range 0 to 140 months).
Conclusions :
IFN is an effective and well-tolerated therapy for ME. However, a long-term therapy is usually necessary. In our case series, 9 out of 82 patients (11%) were able to stop IFN in remission without a subsequent relapse of ME.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.