Pegylated Interferon Alpha-Associated Optic Neuropathy

Berg, Katherine; Nelson, Bruce D.; Harrison, Andrew R.; McLoon, Linda K.; Lee, Michael S.

doi:10.1097/wno.0b013e3181d8e4af

Cited by 19 publications

(15 citation statements)

References 44 publications

(33 reference statements)

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“…It was reported that a hepatitis C patient treated with interferon and ribavirin presented with bilateral, simultaneous NAION. 16 The authors also observed bilateral paresthesia in both hands and feet, reinforcing the hypothesis of a systemic toxicity. Both interferon and ribavirin were discontinued.…”

Section: Discussionmentioning

confidence: 52%

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Nonarteritic anterior ischemic optic neuropathy associated with interferon and ribavirin in a patient with hepatitis C

Sharif

Sheikh

Silva

et al. 2017

American Journal of Ophthalmology Case Reports

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PurposeTo report a case of a temporal artery biopsy negative anterior ischemic optic neuropathy associated with a recently completed course of pegylated interferon 2 α with ribavirin for chronic hepatitis C.ObservationsDespite the early presentation with symptoms and prompt treatment with systemic intravenous steroids the patient experienced deterioration of their optic neuropathy over the following few days. Although nonarteritic anterior ischemic optic neuropathy is a common disorder with known risk factors, the timing of onset of symptoms in our patient was suggestive of a possible etiology related to treatment with ribavirin and interferon 2 α, as found in the previously reported cases.Conclusions and importanceThere have been a few reported cases of the association between the use of interferon/ribavirin for treatment of chronic hepatitis with nonarteritic anterior ischemic optic neuropathy. In these cases stopping the drug caused some improvement of symptoms or halting the progression of optic neuropathy. Having reviewed the literature on previous cases, we postulate that there may be a dose related reaction to explain the delay and deterioration of vision in some cases despite stopping the drugs. We also advise that any person who is started on this treatment for chronic hepatitis are appropriately counselled as to the potential optic nerve side effect of the drug, based on the evidence reported in the literature.

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Section: Discussionmentioning

confidence: 52%

“…This suggested that NAION could be a rare association of interferon/ribavirin therapy, considering that a number of cases might not have been reported. 16 Among these 23 cases, 12 patients were treated with interferon and ribavirin, and 11 patients with interferon alone. 16 …”

Section: Discussionmentioning

confidence: 99%

Nonarteritic anterior ischemic optic neuropathy associated with interferon and ribavirin in a patient with hepatitis C

Sharif

Sheikh

Silva

et al. 2017

American Journal of Ophthalmology Case Reports

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“… 5 The reported cases of NAION with ribavirin were when it was used in combination with interferon, which alone has been associated with NAION. 3 There are two reported cases of NAION occurring in HCV patients with no other risk factors. 6 , 7 Our patient, however, had just completed his six month course of anti-viral treatment prior to his NAION presentation, making HCV infection an unlikely causative agent.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Additionally, pharmaceutical agents including phosphodiesterase-5 inhibitors and interferons have been linked to NAION occurrence. 2 , 3 Interferon therapy, however, has largely been replaced with newer hepatitis C treatment modalities. Harvoni (ledipasvir/sofosbuvir) is a combination of viral polymerase and protein function inhibitors which recently was FDA-approved for hepatitis C treatment.…”

Section: Introductionmentioning

confidence: 99%

A case of non-arteritic anterior ischemic optic neuropathy after completion of Harvoni therapy

Manoharan

Subramanian

2017

American Journal of Ophthalmology Case Reports

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PurposeTo report the first reported case of non-arteritic anterior ischemic optic neuropathy (NAION) associated with the use of Harvoni (Gilead Sciences, Foster City, CA, USA), a newly approved treatment for Hepatitis C.ObservationsWe report a case of NAION in a hepatitis C patient who completed Harvoni therapy just prior to presentation. Harvoni was suspected to be the causative agent given a lack of NAION risk factors in an otherwise healthy young patient.Conclusions and importanceNAION is an acute, painless vision loss that typically affects adults over 50. The mechanism of NAION remains uncertain although numerous associations have been identified including certain medications. Harvoni, a combination drug of ledipasvir/sofosbuvir, is a recently FDA-approved treatment for Hepatitis C. To date, however, no ophthalmological side effects have been reported with its use. Continued surveillance of patients treated with Harvoni will be needed to determine if additional events are observed in the future.

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“…Although it may be effective in treating the eye disease in Behcet's disease it also has ocular side effects which are much more commonly seen in patients receiving interferon with ribavarin for hepatitis C infection [70]. The include cotton wool spots in the nerve fibre layer of the retina which are harmless abut sight loss can also occur from optic nerve involvement [71].…”

Section: Biological Agentsmentioning

confidence: 99%

Ocular Complications of Drugs Used in Rheumatic Disease

Tam¹,

Taylor²,

Lightman

2011

CRR

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Systemically administered medications have long been known to produce detectable ophthalmic signs. Some of these are benign, asymptomatic phenomena that do not require screening or regular follow-up, such as the vortex keratopathy characteristic of amiodarone use, but other medications are potentially toxic to the eye and can damage vision. Ocular toxicity is an established side-effect of several of the immunosuppressive medications in routine use in rheumatological disease, including hydroxychloroqine, but corticosteroids can also cause ocular side-effects in the form of cataract and raised intraocular pressure. Ocular side-effects often occur in a dose-related and reversible manner, but some toxicity reactions are idiosyncratic, irreversible or may progress despite cessation of treatment.

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Pegylated Interferon Alpha-Associated Optic Neuropathy

Cited by 19 publications

References 44 publications

Nonarteritic anterior ischemic optic neuropathy associated with interferon and ribavirin in a patient with hepatitis C

Nonarteritic anterior ischemic optic neuropathy associated with interferon and ribavirin in a patient with hepatitis C

A case of non-arteritic anterior ischemic optic neuropathy after completion of Harvoni therapy

Ocular Complications of Drugs Used in Rheumatic Disease

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