Interferon as a treatment for uveitis associated with multiple sclerosis
Interferon as a treatment for uveitis associated with multiple sclerosis
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DOI：
10.1136/bjo.2004.061119
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发表时间：
2005-10-01
影响因子：
4.1
通讯作者：
Fiehn, C
中科院分区：
文献类型：
--
作者：
Becker, MD;Heiligenhaus, A;Fiehn, C
目的：除了视神经炎（ON），多发性硬化症（MS）也可能累及眼睛，表现为典型的双侧中间葡萄膜炎。本试点研究的目的是评估I型干扰素（IFN）治疗MS相关葡萄膜炎的疗效方法：在这个非随机，回顾性观察病例系列13例（8名女性，5名男性）证实MS和相关葡萄膜炎从5个葡萄膜炎中心谁与干扰素β 1a治疗。结果：除1例患者外，其余患者均为双侧中间葡萄膜炎（共24眼），视力（VA）、眼房水及玻璃体细胞计数、黄斑囊样水肿（CMO）均无明显改变。7例患者在IFN治疗前记录了CMO（n = 13只眼）。中位治疗持续时间为24.6个月（范围7.9 - 78.7）。17眼视力改善（治疗前与末次随访比较），10眼（36%）改善≥ 3 Snellen线。所有眼的房水细胞计数均改善1.2（SD 1.1）级。所有患眼的玻璃体细胞计数均提高1.7（1.4）。仅2例患者在末次血管造影随访时仍有轻微CMO。CMO解决后，或在IFN治疗9 eyes.Conclusions：IFN已被证明有有益的影响，在MS和/或ON患者。如实验性过敏性脑脊髓炎（EAE）和葡萄膜炎的模型中所示，神经和眼科的表现似乎共享相似的致病机制。用IFN治疗MS相关葡萄膜炎似乎对VA、眼内炎症活性和CMO的存在具有有益作用。
Aim: In addition to optic neuritis ( ON), multiple sclerosis ( MS) may also involve the eye with a typically bilateral intermediate uveitis. The aim of this pilot study was to evaluate the efficacy of type I interferons (IFN) for the treatment of MS associated uveitis.Methods: In this non-randomised, retrospective observational case series 13 patients ( eight female, five male) with proved MS and associated uveitis from five uveitis centres who were treated with interferon beta 1a were included. Visual acuity (VA), cell count in the aqueous humour and vitreous, as well as the presence of cystoid macula oedema (CMO) were observed.Results: All except one patient had a bilateral form of intermediate uveitis ( total of 24 eyes). Seven patients had documented CMO before IFN treatment (n = 13 eyes). Median duration of treatment was 24.6 months ( range 7.9 - 78.7). VA improved in 17 eyes ( comparing VA before therapy and at last follow up); while 10 eyes (36%) improved >= 3 Snellen lines. Aqueous cell count improved by 1.2 (SD 1.1) grades in all eyes. Vitreous cell count improved by 1.7 (1.4) in all eyes. Only two patients still had minimal CMO on last follow up angiographically. CMO resolved after or during IFN treatment in nine eyes.Conclusions: IFN has been shown to have beneficial effects in patients with MS and/or ON. As shown in the models of experimental allergic encephalomyelitis (EAE) and uveitis, the neurological and ophthalmological manifestations seem to share similar pathogenic mechanisms. Treatment of MS associated uveitis with IFN appears to have beneficial effects on VA, intraocular inflammation activity, and the presence of CMO.