C型慢性肝炎治療経過中に見られたインターフェロン網膜症

Interferon-associated retinopathy in type C chronic hepatitis

　インターフェロン（IFN）投与中のC型慢性肝炎患者の眼底検査を施行し，24例中10例（42％）に網膜症を認めた。網膜症は視神経乳頭周囲の綿花様白斑と少数の線状網膜表層出血を特徴とし，IFN投与を継続しても自然に消退した。網膜症発症例では非発症例に比べて高齢者が多く，IFN投与による肝機能障害の回復も著明であった。血小板減少や貧血の程度，治療前の肝機能障害や高脂血症の程度には両者間で差がなかった。IFNα2aはIFNβよりも網膜症発症率が高く，投与方法や投与量の違いによると思われた。IFNを投与される患者では，眼科的検査が必要である。

We examined 24 patients with type C chronic hepatitis treated by systemic interferon. Retinopathy was detected in 10 cases, 42%. The retinopathy was characterized by retinal hemorrhages and cotton wool spots in the peripapillary region. They were temporary duration and disappeared while under continued interferon treatment. Patients with retinopathy tended to be higher in age and to show better recovery of liver functions. Patients with or without retinopathy showed no differences in thrombocytopenia or anemia during interferon treatment. They showed no difference in liver functions or hyperlipemia before initiation of treatment. The incidence of retinopathy was higher with interferon-α2a than interferon-β, presumably due to difference in the method of administration and in systemic accumulation of the agents.