Retinopathy in hepatitis C patients due to combination therapy with pegylated interferon and ribavirin

Abstract

Background: To assess the nature, incidence, and risk factors of retinopathy associated with pegylated interferon and ribavirin combination therapy in chronic hepatitis C patients.

Methods: Thirty-two patients with chronic hepatitis C were examined prospectively for changes in fundus findings while they were being treated with pegylated interferon and ribavirin. Patients were followed with sequential ocular examinations for a maximum of 36 weeks.

Results: Eleven of the 32 patients (34.4%) developed retinopathy. Cotton-wool spots were found in six patients, retinal hemorrhages in four, and branch retinal vein occlusion in one (one eye). Hypertension was found to be the most significant risk factor for developing retinopathy.

Conclusion: Significant ocular complications such as an irreversible decrease of visual acuity may develop in patients treated with pegylated interferon. The valid risk factor for developing retinopathy is hypertension. The high rate of retinopathy in patients with hypertension suggests that patients should be carefully monitored.