gms | German Medical Science

Background: Interferon β is commonly used in treatment of multiple sclerosis. Thromboembolic complications are associated with IFN β therapy. Ocular complications have not previously been reported.

Method: We describe a case of branch artery obstruction (BAO) combined with central vein obstruction (CVO) in a female patient undergoing IFN β therapy.

Results: A 44-year-old woman was evaluated for sudden and painless decreased vision in her right eye. For ten years she had been receiving IFN β for multiple sclerosis. On examination, her visual acuity was 1/35 on her right eye. Fundus examination revealed a CVO. In addition fluorescein angiogram showed 2 non perfusion areas in the papillomacular bundle and nasal of the optic nerve, compatible with BAO. The OCT revealed a cystoid macular edema. The patient was admitted for heamodilution therapy and underwent a systemic workup. Diabetes and arterial hypertension have been ruled out, hypercoagulable status and rheumatoid factors studies were negative. The patient denied the use of hormonal contraception.

Conclusion: CVO occurring together with a simultaneous BAO has only been reported with IFN α therapy in combination with ribavirin in hepatitis C patients. Ribavirin may be a contributing factor to the occurrence of IFN α retinopathy because of its synergistic action when used together with IFN. The occurrence of a combined retinal vascular occlusion in our patient, in which we did not reveal any other risc factors for thromboembolic events, points toward an association with the long-term use of IFN β.