ORIGINAL ARTICLE, Interferon Alpha-2A Treatment for Serpiginous Choroiditis

Abstract

Purpose: To describe the management and long-term outcome of patients with serpiginous choroiditis (SPC) treated with interferon (IFN) alpha-2a. Design: Prospective, non-comparative case series. Participants: Five patients (8 eyes) with active vision-threatening SPC, who failed to respond and/or presented with side effects to the combination of steroid-cyclosporin-A or chlorambucil, at a tertiary care referral center. Intervention: The patients were treated with IFN alpha-2a (4,500,000 IU, 3 times a week for the first 3 months, followed by once a week for the next 3 months). Prednisone was also given initially, then tapered and discontinued. Main outcome measures: Visual acuity, control of inflammation, duration of drug-free disease remission, and side effects of IFN alpha-2a therapy. Results: Argon laser photocoagulation (ALP) was applied in three eyes with extrafoveal choroidal neovascular membrane (CNM). All active lesions, including complicating subfoveal CNM in one eye, resolved within six months. The patients had no recurrences and recovered (4 out of 8; 50%) or maintained (4 out of 8; 50%) useful vision during the 16–48-month follow-up. Except for flu-like symptoms at the beginning of the therapy, no noticeable adverse reaction was observed. Conclusions: IFN alpha-2a seems to be a novel treatment option for SPC. In the five patients (8 eyes) with SPC, who were intolerant or unresponsive to the combination of steroid-cyclosporin-A or chlorambucil, IFN alpha-2a treatment prevented recurrences and stabilized the lesions during the long-term follow-up (16–48 months). These promising results support the use of this mode of therapy in controlled clinical trials.