Ocular effects of combined therapy with pegylated interferon (PegINF) and ribavirin (RBV) in hepatitis C

Purpose To evaluate ocular effects of combined therapy with pegylated interferon and ribavirin in hepatitis C. Methods 18 patients (36 eyes) received combined therapy based on the presence of HCV antibodies in the serum and positive RT – PCR test results for HCV RNA. Patients were examined at baseline, months 1, 3, 6 after initiation and 6 months after completion of antiviral treatment. Primary outcome was best corrected visual acuity (BCVA) and secondary outcomes were slit lamp examination, intraocular pressure, foveal thickness, and P1 Multifocal Electroretinography( mfERG) amplitude. Results 13 patients (26 eyes) completed the study. 2 of 13 (15%) patients had exacerbation of dry eye syndrome and 2 of 13 (15%) developed retinopathy. Therapy was discontinued in patients with retinopathy with remission of retinal changes after 3 months. No significant changes in other parameters were observed. Conclusion Patients treated with PegINF-RBV have a potential risk of ocular complications and require a regular ophthalmic examination. We suggest ocular examination and follow up protocol for patients treated with interferon-ribavarin therapy to limit potential side effects.