Recent advances in the Ophthalmological Uses of Interferon
Mohammed Ahmed Ghazy Ahmed;
Abstract
Interferons are natural chemical messengers or cytokines that play an important rule in the body’s immune response. Interferons are characterized by their antiviral, anti-proliferative, anti-tumor and immunomodulatory effect. So now they are widely used in treatment of viral infection, tumors and some auto immune diseases.
PEGylated interferon-alpha is a recent therapy, when used with the antiviral drugribavirin it gives a great effective in treatment of hepatitis C. At least 75%of people with hepatitis C benefit from interferon treatment.
Interferons are also used in other systemic diseases like lymphomas, melanoma, renal cell carcinoma, ovarian carcinoma, Multiple sclerosis, hairy cell leukemia, chronic granulomatous disease and pulmonary tuberculosis.
In ophthalmological diseases, interferons have shown encouraging results alone or combined with corticosteroid and/or immunosuppressant. The type 111 interferons, which include IFN-α & IFN-β are the most clinically relevant in the context of ocular inflammation diseases.
Interferon is the first biological agent used for the treatment of uveitis& BD before the advent of anti-TNF. IFN-α is effective treatment for BD. The most impressive results have been achieved for severe and/or refractory ocular manifestations.
IFN-α, with its immunomodulatory, anti-proliferative and anti-angiogenic actions, was effective in improving BCVA and reducing central macular thickness in resistant Diabetic macular edema. IFN-β has superiority over MTX in treatment of resistant inflammatory macular edema.
IFN-β is widely used as first line treatment for relapsing remitting multiple sclerosis. Treatment with IFN-β during the earlier disease phase significantly improves patient’s quality of life.
Herpetic eye disease is the most common infectious cause of corneal blindness in developed countries. IFNα-2b eye drops combined with antiviral agent is very effective in the control of HSV-1 replication and its spread leading to a better clinical outcome for those diagnosed with herpetic keratitis.
Ocular malignancies are the major life threatening ocular conditions. Its treatment still depends on interventional procedures like surgical resection, radiation and chemotherapy. Due to its antiproliferative and immunomodulatory effect, IFNs have been shown to be effective therapy for ocular tumors.
Multiple neoplasms in ophthalmology can be now treated with interferons. The encouraging results were obvius in treatment of conjunctival papilloma, melanoma, lymphoma and conjunctival intra-epithelial neoplasm.
Both basal cell carcinoma and squamous cell carcinoma which are usually treated with destructive methods can be now treated with interferons but without tissue destruction.
Complications of IFN therapy mainly depend on the route of administration, concentration of the preparation used, age and medical condition of the patient.Therapy with IFN-alpha has been associated with the presence of systemic side effects, such as flu-like syndrome, arthralgia, platelet reduction, leukopenia, depression, delirium, thyroid disorders and ocular side effects.
Most of the ocular side effects occurring during IFN-alpha treatment are benign, transient and are mainly represented by the classical “specific” IFN-related retinopathy, characterized by cotton wool spots, retinal hemorrhages, and microaneurysms.
Conjunctivitis and watery eye may be associated with topical IFN eye drops. Retinal vascular occlusion, choroidal neovascularization, macular edema and optic neuropathy may also be complication of IFN drug.
Interferons route of administration could be intramuscular, subcutaneously, intravitreal, intra-lesional, subconjunctival or topical in the form of eye drops.
PEGylated interferon-alpha is a recent therapy, when used with the antiviral drugribavirin it gives a great effective in treatment of hepatitis C. At least 75%of people with hepatitis C benefit from interferon treatment.
Interferons are also used in other systemic diseases like lymphomas, melanoma, renal cell carcinoma, ovarian carcinoma, Multiple sclerosis, hairy cell leukemia, chronic granulomatous disease and pulmonary tuberculosis.
In ophthalmological diseases, interferons have shown encouraging results alone or combined with corticosteroid and/or immunosuppressant. The type 111 interferons, which include IFN-α & IFN-β are the most clinically relevant in the context of ocular inflammation diseases.
Interferon is the first biological agent used for the treatment of uveitis& BD before the advent of anti-TNF. IFN-α is effective treatment for BD. The most impressive results have been achieved for severe and/or refractory ocular manifestations.
IFN-α, with its immunomodulatory, anti-proliferative and anti-angiogenic actions, was effective in improving BCVA and reducing central macular thickness in resistant Diabetic macular edema. IFN-β has superiority over MTX in treatment of resistant inflammatory macular edema.
IFN-β is widely used as first line treatment for relapsing remitting multiple sclerosis. Treatment with IFN-β during the earlier disease phase significantly improves patient’s quality of life.
Herpetic eye disease is the most common infectious cause of corneal blindness in developed countries. IFNα-2b eye drops combined with antiviral agent is very effective in the control of HSV-1 replication and its spread leading to a better clinical outcome for those diagnosed with herpetic keratitis.
Ocular malignancies are the major life threatening ocular conditions. Its treatment still depends on interventional procedures like surgical resection, radiation and chemotherapy. Due to its antiproliferative and immunomodulatory effect, IFNs have been shown to be effective therapy for ocular tumors.
Multiple neoplasms in ophthalmology can be now treated with interferons. The encouraging results were obvius in treatment of conjunctival papilloma, melanoma, lymphoma and conjunctival intra-epithelial neoplasm.
Both basal cell carcinoma and squamous cell carcinoma which are usually treated with destructive methods can be now treated with interferons but without tissue destruction.
Complications of IFN therapy mainly depend on the route of administration, concentration of the preparation used, age and medical condition of the patient.Therapy with IFN-alpha has been associated with the presence of systemic side effects, such as flu-like syndrome, arthralgia, platelet reduction, leukopenia, depression, delirium, thyroid disorders and ocular side effects.
Most of the ocular side effects occurring during IFN-alpha treatment are benign, transient and are mainly represented by the classical “specific” IFN-related retinopathy, characterized by cotton wool spots, retinal hemorrhages, and microaneurysms.
Conjunctivitis and watery eye may be associated with topical IFN eye drops. Retinal vascular occlusion, choroidal neovascularization, macular edema and optic neuropathy may also be complication of IFN drug.
Interferons route of administration could be intramuscular, subcutaneously, intravitreal, intra-lesional, subconjunctival or topical in the form of eye drops.
Other data
| Title | Recent advances in the Ophthalmological Uses of Interferon | Other Titles | الأستخدامات الحديثـه لعقار الأنترفيرون في علاج امراض العيون | Authors | Mohammed Ahmed Ghazy Ahmed | Issue Date | 2015 |
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