To report a case of a combined branch retinal artery and vein occlusion in a patient with hepatitis C treated with interferon and ribavirin.
Methods
A 29-year-old man with a 1-week history of sudden visual field defect and decrease of central visual acuity was examined.
Results
Ophthalmoscopy and fluorescein angiography demonstrated an ischemic whitening of the inferior hemi-retina involving part of the macular region, numerous intraretinal hemorrhages, and a significant delay in arterial and vein filling of the dye.
Conclusions
The findings of a retinopathy associated with interferon and ribavirin treatment of hepatitis C are important. The symptomatic permanent visual field defect and decrease of central visual acuity developing following a branch retinal artery and vein occlusion event emphasizes the need for careful and regular ocular monitoring of patients receiving interferon for hepatitis C.
JainK., LamW.C., WaheebS.Retinopathy in chronic hepatitis C patients during interferon treatment with ribavirin.Br J Ophthalmol2001; 85: 1171–3.
14.
HoeraufH., Schmidt-ErfurthU., Asiyo-VogelM., LaquaH.Combined choroidal and retinal ischemia during interferon therapy: indocyanine green angiographic and microperimetric findings.Arch Ophthalmol2000; 118: 580–2.
SchulmanJ.A., LiangC., KooragayalaL.M., KingJ.Posterior segment complications in patients with hepatitis C treated with interferon and ribavirin.Ophthalmology2003; 110: 437–42.
17.
NishiwakiH., OguraY., MiyamotoK.Prednisolone, platelet-activating factor receptor antagonist, or superoxide dismutase reduced leukocyte entrapment induced by interferon alpha in retinal microcirculation.Invest Ophthalmol Vis Sci1997; 38: 811–6.
18.
NishiwakiH., OguraY., MiyamotoK.Interferon alfa induces leukocyte capillary trapping in rat retinal microcirculation.Arch Ophthalmol1996; 114: 726–30.
19.
SuganoS., SuzukiT., WatanabeM.Retinal complications and plasma C5a levels during interferon alpha therapy for chronic hepatitis C.Am J Gastroenterol1998; 93: 2441–4.
20.
SuganoS., YanagimotoM., SuzukiT.Retinal complications with elevated circulating plasma C5a associated with interferon-alfa-therapy for chronic active hepatitis C.Am J Gastroenterol1994; 89: 2054–6.
21.
AbeT., NakajimaA., SatohN.Clinical characteristics of hepatitis C virus-associated retinopathy.Jpn J Ophthalmol1995; 39: 411–9.
22.
GassJ.D.M.Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment, 4th ed.St. Louis: Mosby; 1997: 452.
23.
VioliF., FerroD., BasiliS.Increased rate of thrombin generation in hepatitis C virus cirrhotic patients. Relationship to venous thrombosis.J Invest Med1995; 43: 550–4.
24.
HerzenbergA.M., TelfordJ.J., De LucaL.G.Thrombotic microangiopathy associated with cryoglobulinemic membranoproliferative glomerulonephritis and hepatitis C.Am J Kidney Dis1998; 31: 521–6.
