January 31, 2003
Severe interferon associated retinopathy
BJO Feb 2003
A 56 year old man presented with a 3 week history of deterioration and distortion of right vision. Visual acuities (VA) were 6/60 right and 1/60 left. Funduscopy revealed bilateral extensive peripapillary cotton wool spots, retinal thickening, optic disc hyperaemia, and blot haemorrhages. Arteriolar changes were minimal. He was anaemic (Hb 10.6 gdl/l) and slightly thrombocytopenic (platelets 93 x 109/l). Plasma viscosity was 1.59 (normal 1.5–1.7). Renal function was normal at presentation. He underwent peripheral blood stem cell transplant for multiple myeloma 8 months previously after having melphalan 110 mg/m2 and total body irradiation (including the head) in a total dose of 1200 cGy given in six fractions over 3 days. He then had interferon alfa therapy for 4 months, initially 3 mega units three times a week, later reduced to twice a week. It was stopped immediately after visual deterioration.
Posted by M.Miraftab MD,
Posted by mmiraftab at January 31, 2003 02:59 PM