Abstract

SO.20.02

Interferon induced ocular Sarcoidosis?

Doycheva D., Deuter C., Stübiger N., Zierhut M.
University Eye Hospital, Tuebingen

Objective: Interferon alpha, used in the treatment of viral hepatitis, metastatic skin melanoma and Behçet's Disease, is known to induce a variety of ocular side effects. Recently it was reported about the induction of sarcoidosis by Interferon alpha. We analyse patients from the Eye Department for uveitis, possibly induced by Interferon alpha.
Methods: We report about 3 patients who had developed typical signs of ocular sarcoidosis under treatment with Interferon alpha. Underlying disorder was a chronic hepatitis C in all patients. In 2 patients, regular Interferon alpha had been used, in another patient pegylated Interferon alpha-2b. All patients also had Ribavirin.
Results: In all 3 patients a panuveitis was diagnosed. Mean age of the patients was 50 years. Mean duration of Interferon treatment before start of the uveitis was 10 months. In one patient, the diagnosis of sarcoid induced uveitis was confirmed by positive chest CT-findings. In another patient, an elevated ACE level was found. Clinically all patients demonstrated a granulomatous uveitis with granulomas of various sizes on the choroid, in one patient additionally snow balls. Regarding therapy, in one patient a vitrectomy had been performed (due to a first diagnosis of endophthalmitis), while the other patients improved by reduction of Interferon alone. The therapy of Ribavirin was continued.
Conclusions: It seems that Interferfon alpha can induce sarcoid uveitis, which typically seems to involve the lungs less frequently, as also reported in the rare literature. With early diagnosis the prognosis of the uveitis seems to be very good. Until today no Behçet's patients have been reported who have developed sarcoidosis.

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