C 型慢性活動性肝炎の Interferon 治療と眼底出血

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We observed retinal hemorrhage in three patients with type C chronic active hepatitis, in whom subjective complaints such as impairment of visual acuity and flying specks had been manifested during interferon (IFN) therapy. In 34 patients consisting of 20 patients during IFN therapy and 14 patients shortly after the therapy, fundus examinations were carried out, and retinal hemorrhage without any symptoms was recognized in additional four patients among the remaining 17 patients during the IFN therapy. Ophthalmic examinations on retinal hemorrhage in the totally seven patients, suggested that the retinal hemorrhage was one of side effects of the IFN treatment. Supeficial hemorrhage and cotton wool patches around the optic disc appeared to be characteristic for retinal hemorrhage during the IFN therapy. Comparing clinical profiles and biochemical laboratory data between the seven hemorrhagic and the 27 non-hemorrhagic patients, we concluded that in the patients manifested the retinal hemorrhage, diabetes mellitus was more frequently associated, and decrease in blood platelet counts, % decrement of the platelet counts and elevation of serum triglyceride concentration after the IFN therapy were more remarkable with statistical significance (t-test, p<0.05, respectively). The patients with retinal hemorrhage did not show severe impairment of visual acuity. Moreover, the improvement of retinal hemorrhage was observed in the four patients even during the IFN therapy. Thus, we consider that careful ophthalmologic follow-up enables IFN therapy to be continued. In addition, fundus examination is necessary for all patients under IFN therapy since four of the 34 patients had retinal hemorrhage without any symptoms.
社団法人日本肝臓学会の論文

C 型慢性活動性肝炎の Interferon 治療と眼底出血

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