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Alpha-interferon-treatment of a Cystoid Macular-edema in Behçet´s Disease A Case Report
1Deuter C. M. E., 2Kötter I., 2Günaydin I., 3Zierhut M., 3Stübiger N.,
1Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Erkrankungen des vorderen und hinteren Augenabschnittes (Tübingen)
2Eberhard-Karls-Universität Tübingen, Medizinische Universitätsklinik, Abt. II (Tübingen)
3Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Abt. I (Tübingen)
Background: Beside a possible occlusive vasculitis the chronic cystoid macular oedema represents a substantial reason for poor prognosis of visual acuity in Behçet´s disease. This can often be influenced by corticosteroids, azetazolamide as well as immunosuppressants only insufficiently.
Case report: We report on a 24 year old Turkish female patient with known posterior uveitis due to Behçet´s disease (HLA-B51+). Despite systemic immunosuppressive treatment with azathioprine 150 mg/day in combination with prednisolone 2.5 mg/day she developed a cystoid macular oedema in her left eye without other signs of inflammation. Visual acuity was reduced to 0.3. The diagnosis was proven by fluorescence angiography and by Optical Coherence Tomography (OCT; foveal thickness = 550 µm). Increasing the prednisolone dosage to 50 mg/day was of no effect. After cessation of azathioprine and reduction of the prednisolone dosage to 10 mg/day we initiated a therapy with interferon-a2a in a dosage of 3 x 106 IU/day (injected subcutaneously). After 5 weeks the cystoid macular oedema had regressed completely and was no longer detectable by fluorescence angiography and by OCT (foveal thickness = 160 µm). Visual acuity had increased to 1.0. After another 10 weeks and after a dosage reduction of interferon to 3 x 106 IU every other day and prednisolone to 7,5 mg/day there were still no signs for recurrence. Side effects of the interferon therapy were flu-like symptoms following the first two injections, alopecia and a secondary fibromyalgia.
Conclusions: In this case interferon-a2a in combination with low dose corticosteroids proved as a very effective treatment of a cystoid macular oedema in posterior uveitis due to Behçet´s disease.