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Interferon as a treatment for uveitis associated with multiple sclerosis

¹ Interdisciplinary Uveitis Center, University of Heidelberg, Germany
² Department of Ophthalmology, University of Heidelberg, Germany
³ Department of Ophthalmology at St Franziskus Hospital, Münster, Germany
⁴ Department of Ophthalmology, University of Essen, Germany
⁵ Department of Neurology, University of Heidelberg, Germany
⁶ Department of Ophthalmology, University of Vienna, Austria
⁷ Department of Ophthalmology, University of Tübingen, Germany
⁸ Department of Internal Medicine, University of Heidelberg, Germany and Centre of Rheumatic Diseases, Baden-Baden, Germany

Correspondence to:
Correspondence to:
Matthias D Becker
MD, PhD, FEBO, Interdisciplinary Uveitis Center, University of Heidelberg, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany; matthias.becker{at}uveitiscenter.de

ABSTRACT
Aim: In addition to optic neuritis (ON), multiple sclerosis (MS) may also involve the eye with a typically bilateral intermediate uveitis. The aim of this pilot study was to evaluate the efficacy of type I interferons (IFN) for the treatment of MS associated uveitis.

Methods: In this non-randomised, retrospective observational case series 13 patients (eight female, five male) with proved MS and associated uveitis from five uveitis centres who were treated with interferon ß1a were included. Visual acuity (VA), cell count in the aqueous humour and vitreous, as well as the presence of cystoid macula oedema (CMO) were observed.

Results: All except one patient had a bilateral form of intermediate uveitis (total of 24 eyes). Seven patients had documented CMO before IFN treatment (n = 13 eyes). Median duration of treatment was 24.6 months (range 7.9–78.7). VA improved in 17 eyes (comparing VA before therapy and at last follow up); while 10 eyes (36%) improved 3 Snellen lines. Aqueous cell count improved by 1.2 (SD 1.1) grades in all eyes. Vitreous cell count improved by 1.7 (1.4) in all eyes. Only two patients still had minimal CMO on last follow up angiographically. CMO resolved after or during IFN treatment in nine eyes.

Conclusions: IFN has been shown to have beneficial effects in patients with MS and/or ON. As shown in the models of experimental allergic encephalomyelitis (EAE) and uveitis, the neurological and ophthalmological manifestations seem to share similar pathogenic mechanisms. Treatment of MS associated uveitis with IFN appears to have beneficial effects on VA, intraocular inflammation activity, and the presence of CMO.

Abbreviations: CMO, cystoid macula oedema; EAE, experimental allergic encephalomyelitis; IFN, interferon; MRI, magnetic resonance imaging; MS, multiple sclerosis; ON, optic neuritis; VA, visual acuity

Keywords: uveitis; multiple sclerosis; interferon; therapy; human

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