CAJ | 학술논문

干扰素具有抑制病毒复制、免疫调节及抗肿瘤等多种效应,目前各种类型的干扰素在临床上广泛用于多种疾病的治疗.干扰素相关性眼病是干扰素治疗过程中出现相对少见的一种副作用,临床表现形式多样,包括干扰素相关性视网膜病变、干扰素相关性视神经病变和非典型眼部病变.其中干扰素相关性视网膜病变最常见,眼底表现为视乳头旁或后极部视网膜散在点状白色棉絮斑和/或点片状出血,大部分患者无症状,可不予特殊处理,病变即可消失自愈.但少数干扰素相关性眼病较重的患者,如出现前部缺血性视神经病变、视网膜血管阻塞、黄斑水肿、Vogt-小柳-原田综合征等,患者可出现不可逆性视功能损害,此时应终止干扰素治疗,并积极给予相应的治疗措施,如全身糖皮质激素治疗、抗血管内皮成长因子药物玻璃体内注射以及眼底激光等.详细询问病史,及时发现高危因素如患有高血压病、糖尿病、糖尿病视网膜病变或有Vogt-小柳-原田综合征史等,定期眼底检查,有助于本病的早期诊治.
간우소구유억제병독복제、면역조절급항종류등다충효응,목전각충류형적간우소재림상상엄범용우다충질병적치료.간우소상관성안병시간우소치료과정중출현상대소견적일충부작용,림상표현형식다양,포괄간우소상관성시망막병변、간우소상관성시신경병변화비전형안부병변.기중간우소상관성시망막병변최상견,안저표현위시유두방혹후겁부시망막산재점상백색면서반화/혹점편상출혈,대부분환자무증상,가불여특수처리,병변즉가소실자유.단소수간우소상관성안병교중적환자,여출현전부결혈성시신경병변、시망막혈관조새、황반수종、Vogt-소류-원전종합정등,환자가출현불가역성시공능손해,차시응종지간우소치료,병적겁급여상응적치료조시,여전신당피질격소치료、항혈관내피성장인자약물파리체내주사이급안저격광등.상세순문병사,급시발현고위인소여환유고혈압병、당뇨병、당뇨병시망막병변혹유Vogt-소류-원전종합정사등,정기안저검사,유조우본병적조기진치.
Interferon (IFN) has antiviral,antiproliferative and immunomodulating effects.The various types of interferon are widely used in the treatment of many diseases in clinic.Interferon-associated ophthalmologic complication is a relatively rare side effect in the process of treatment,and has diverse clinical manifestations,which can mainly be divided into:interferon associated retinopathy,interferon associated optic neuropathy and atypical ocular side effects.Interferon associated retinopathy,the most common form,manifests as scattered white cotton wool spots and/or small retinal hemorrhages around the disc and through the posterior pole.Most of the patients are visually asymptomatic and do not require any treatment.These lesions can resolve over time.But a minority of patients may develop serious interferon associated ophthalmologic complications,such as ischemic optic neuropathy,retinal vascular obstruction,macular edema,VogtKoyanagi-Harada disease.These patients often complain of visual damage which may lead to irreversible visual impairment.For these cases,the IFN therapy must be terminated,and aggressive early interventions must be offered,such as systemic hormone treatment,intravitreal injection of anti-VEGF agents and retinal laser coagulation,etc.In order to avoid permanent visual impairment,the physicians or ophthalmologists should be highly aware of these diseases,and ask detailed questions about the systemic disease and the history of any eye diseases,and pay attention to high-risk factors:hypertension,diabetes mellitus,diabetic retinopathy,or a history of Vogt-Koyanagi-Harada disease.For high risk patients,periodically eye examinations are necessary.