Clinical Features of Retinopathy in Chronic Hepatitis B Patients With Treated With Peginterferon

Yong Dae Kwon; Ji Won Lim

doi:10.3341/jkos.2011.52.1.41

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Kwon and Lim: Clinical Features of Retinopathy in Chronic Hepatitis B Patients With Treated With Peginterferon

Original Article

J Korean Ophthalmol Soc 2011;52(1):41-45.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.1.41

Clinical Features of Retinopathy in Chronic Hepatitis B Patients With Treated With Peginterferon

Yong Dae Kwon, MD, Ji Won Lim, MD

Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea

Address reprint requests to Ji Won Lim, MD Department of Ophthalmology, Hallym University Chuncheon Sacred Heart Hospital #153 Gyo-dong, Chuncheon 200-060, Korea Tel: 82-33-240-5176, Fax: 82-33-255-5210, E-mail: jiwoneye@hallym.or.kr

Received 23 July 2010 Revised 14 October 2010 Accepted 9 December 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical features of retinopathy in chronic hepatitis B patients treated with peginterferon.

Methods

Chronic hepatitis B patients treated with peginterferon were evaluated during regular routine ophthalmic examinations including fundus examination before and during the 1-year follow-up after treatment. A total of 88 patients were included in the study.

Results

Retinopathy developed in 11 (12.5 %) out of 88 patients at a mean of 7 weeks after initiation of treatment. Peginterferon treatment was continued in all patients and retinal abnormalities including cotton wool spot, retinal hemorrhage and microaneurysm resolved without visual impairment. The incidence of hypertension between the retinopathy group and the group without retinopathy was significantly different (P = 0.020).

Conclusions

The incidence of retinopathy with peginterferon in chronic hepatitis B patients was low and the prognosis was benign. Thus, routine screening for peginterferon retinopathy is not necessary.

Keywords: Chronic hepatitis B, Pegylated Interferon, Retinopathy

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Figure 1.

The fundus photographs of peginterferon-associated-retinopathy in 36-year-old male patient. He started with peginterferon for treatment of chronic hepatitis B. After 1 month, cotton-wool spots with fluffy margin were noted at posterior fundus around the optic disc on both eyes. After 3 months, the lesions were completely disappeared without cessation of peginterferon.

Table 1.

Comparison of characteristics in chronic hepatitis B patients with and without peginterferon-associated-retinopathy

Variables	With retinopathy (n = 11)	Without retinopathy (n = 77)	P-value
Age (yr)	36.4 ± 8.0	37.5 ± 10.1	0.738^*
Gender male: female	6:5	40:37	0.207^†
Antiviral combination therapy	0	10	0.204^†
Alanine aminotransferase (IU/L)	143.2 ± 98.4	258.8 ± 121.2	0.209^‡
HBV-DNA (×10⁶ copies/mL)	58.0 ± 45.9	40.3 ± 30.8	0.301^‡
Liver biopsy Grade^∏ 1:2:3:4	6:4:1:0	27:30:18:2	0.171^§
Hypertension	2 (18.2%)	2 (2.5%)	0.020^§
Diabetes mellitus	0	2 (2.5%)	0.589^§
Cholesterol (mg/dl)	169.7 ± 39.1	169.1 ± 28.9	0.948^*
Hemoglobin (g/dl)	13.2 ± 2.1	16.9 ± 3.0	0.442^‡
WBC (×10⁶/uL)	4.76 ± 2.8	5.17 ± 2.9	0.525^‡
Platelet (×10³/uL)	184.2 ± 78.9	213.5 ± 89.4	0.102^‡
Creatine (mg/dl)	0.88 ± 0.15	0.94 ± 0.12	0.261^‡

SD = standard deviation.

^* two sample t-test

^† Chi-square test

^‡ Mann-Whitney test

^§ Fisher's exact test

^∏ METAVIR scoring.

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