Interferon Alfa-2a in the Treatment of Subfoveal Choroidal Neovascularization

Thomas, Matthew A.; Ibanez, Hector E.

doi:10.1016/s0002-9394(14)71451-5

Cited by 46 publications

(15 citation statements)

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“…(ARMD) may be treated in several different ways, including photocoagulation (Macular Photocoagulation Study Group 1991Group , 1993Group , 1994Hawkins 1994), radiation therapy (Bergink et al 1994), pharmacologic therapy (Thomas & Ibanez 1993;Miller et al 1993;Gillies et al 1993;Chan et al 1994;Poliner et al 1994), and invasive intervention, such as a vitrectomy for the removal of subretinal hemorrhage (Ibanez et al 1995;Lewis 1995;Kamei et al 1996) or resection of choroidal neovascularization (CNV) (de Juan & Machemer 1988;Lambert et al 1992; Thomas et al 1992). Despite the merits of these procedures, photocoagulation of subfoveal CNV sometimes worsens visual acuity, radiation therapy is often complicated by a high incidence of recurrence, and pharmacologic therapy, such as interferon-å (Thomas & Ibanez 1993;Miller et al 1993;Gillies et al 1993;Chan et al 1994;Poliner et al 1994), often produces inconsistent results.…”

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“…Despite the merits of these procedures, photocoagulation of subfoveal CNV sometimes worsens visual acuity, radiation therapy is often complicated by a high incidence of recurrence, and pharmacologic therapy, such as interferon-å (Thomas & Ibanez 1993;Miller et al 1993;Gillies et al 1993;Chan et al 1994;Poliner et al 1994), often produces inconsistent results. Pars plana vitrectomy to resect CNV has met with some success in recent years (de Juan & Machemer 1988;Lambert et al 1992; Thomas et al 1992).…”

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confidence: 99%

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Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration

Ikeda

Sawa

Koizumi

et al. 2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Objective: In age-related macular degeneration, the posterior vitreous surface often remains attached to a higher degree than expected for the patient's age, suggesting the involvement of the posterior vitreous membrane in the pathophysiology of choroidal neovascularization. Thus, we performed simple pars plana vitrectomy and artificial posterior vitreous detachment in order to induce regression of choroidal neovascularization.

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Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration

Ikeda

Sawa

Koizumi

et al. 2000

Acta Ophthalmologica Scandinavica

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“…Distance visual acuity was improved or unchanged in 16 patients in the interferon alfa-2a group compared with 10 in the placebo group, and worsened in only two patients in the interferon alfa-2a group compared with 10 in the placebo group (Fig 1). The difference was statistically significant in favour of interferon alfa-2a (p=0-023; 95% CI, 13% to 65%).…”

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confidence: 93%

Interferon alfa-2a modifies the course of subfoveal and juxtafoveal choroidal neovascularisation.

Engler

Sander

Villumsen

et al. 1994

British Journal of Ophthalmology

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The first double masked placebo controlled trial of interferon alfa-2a for the treatment of overt choroidal neovascular membranes is presented. A total of 43 consecutive patients were randomised to double masked treatment with either interferon alfa-2a, 3 million IU subcutaneously three times a week or matching placebo, for a period of 8 weeks. End of study changes from baseline in distance and near visual acuity, macular visual field, contrast sensitivity, and macular morphology (fluorescein angiography) were assessed. The between group difference in distance visual acuity, the primary efficacy variable, was significant in favour of interferon alfa-2a (p=0.023). Fluorescein angiograms, macular visual fields, and near vision all showed a trend in favour of interferon alfa-2a. It was concluded that, at the dosage used in this study, interferon alfa-2a is a reasonably well tolerated and apparently effective short term treatment of subfoveal and juxtafoveal choroidal neovascularisations. (BrJ7 Ophthalmol 1994; 78: 749- Age-related macular degeneration (ARMD) has been estimated to affect around 2% of the population between the ages of 52 to 64 years in industrialised countries. This figure increases to 10% between the ages of 65 and 74 years and further increases to 30% between the ages of 74 and 85 years.' As the proportion of elderly people in the population continues to rise, the need for an effective treatment is evident, particularly as the disease is believed to be the leading cause of blindness in the developed world.Two main types of ARMD are recognised. The more common form, responsible for 80% of reported cases of the disease, is non-exudative.

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“…The successful outcome was limited to those with small, recent subretinal neovascular membranes. Subsequent to this publication several pilot studies have reported less successful results (Loughnan et al 1992;Thomas et al 1993;Tholen et al 1993;Engler et al 1993;Lewis et al1993). All of these studies have been small (5-20 patients) and non-controlled.…”

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Interferon alpha‐2a in the treatment of exudative senile macular degeneration

Jaakkola

Anttila²,

Immonen

1994

Acta Ophthalmologica

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We performed a pilot study of 10 patients with the objective to determine the efficacy of interferon alpha-2a in the treatment of age-related macular degeneration with freshly diagnosed choroidal neovascular membrane. Interferon was given at a dose of 3 MIU/m2 three times a week for 8 weeks. Mean age of the patients was 74 years. In 3 patients we combined laser photocoagulation of extrafoveal part of the choroidal neovascular membrane to interferon therapy. The patients were followed up for 1 year after termination of interferon treatment. In 1 patient a visual improvement of two Snellen lines was noted, while in 7 patients visual acuity remained the same during the treatment (includes 3 patients treated with combined Krypton-laser photocoagulation). In 2 patients there was a decrease in acuity of one line. Six months later visual acuity had deteriorated in 7 patients and 1 year later all the patients had visual acuity < or = 20/200. We did not find any regression of choroidal neovascular membrane in fluorescein angiography in any of the patients during the treatment except the laser-treated area. At the 6-month follow-up there was still leakage or choroidal neovascular membrane growth in 6 patients. Combined interferon-laser therapy did not prove to be more effective in preventing the membrane growth. Side-effects included weakness, apathy, and fatigue in this elderly population. Our results indicate that treatment with 3 MIU/m2 interferon for 8 weeks is not an effective treatment for subfoveal choroidal neovascular membranes.

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Interferon Alfa-2a in the Treatment of Subfoveal Choroidal Neovascularization

Cited by 46 publications

References 11 publications

Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration

Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration

Interferon alfa-2a modifies the course of subfoveal and juxtafoveal choroidal neovascularisation.

Interferon alpha‐2a in the treatment of exudative senile macular degeneration

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