Posterior segment complications in patients with hepatitis C treated with interferon and ribavirin

Purpose: To determine the incidence and type of posterior segment complications associated with the use of interferon alpha 215 and ribavirin in patients with chronic hepatitis C. Design: A prospective noncomparative case series. Participants: Forty-two patients (84 eyes). Methods: Patients with chronic hepatitis C were evaluated for ocular changes while being treated with interferon alpha 2b and ribavirin. Patients were followed with sequential ocular examinations for 4 to 20 months. Main Outcome Measures: Occurrence of posterior segment complications while on interferon and ribavirin therapy. Results: Twenty-seven patients developed retinopathy. The retinopathy consisted of single-to-multiple cotton-wool spots and retinal hemorrhage and was transient in all cases. An additional patient (age 46) presented with asymptomatic disc edema and hemorrhage. One other individual developed a symptomatic permanent monocular visual field defect. Therapy was discontinued in three patients because of severe posterior segment pathology. Conclusions: Our study demonstrated that a high incidence of retinopathy is associated with the treatment of hepatitis C using interferon and ribavirin, but that this form of retinopathy is relatively benign. Regular ophthalmic monitoring should be performed in patients undergoing this treatment. Ophthalmology 2003;110: 437-442 (C) 2003 by the American Academy of Ophthalmology.