Retinal Complications In Patient With Chronic Hcv On Interferon Therapy In Egypt

Research Article
Mohamed Abdel-Fattah El Malatawy, Ahmed Samir Abo Halima, Nevine Musa, Ossama Ashraf Ahmed and Karim M. Naguib

Introduction: Hepatitis C virus (HCV) infects up to 170 million people throughout the world causing chronic liver disease, liver cirrhosis and hepatocellular carcinoma. According to recent guidelines, the combination of pegylated interferon (PEG- IFN) α and ribavirin is still regarded as the standard chemotherapy for chronic hepatitis C (CHC). Various adverse effects, including ophthalmological side effects have been reported with the use of IFN. Aim of the study: To evaluate retinal complications in patient with chronic HCV on interferon therapy. Patients and methods: The study included 300 patients with CHC who received interferon therapy for 48 weeks at the outpatient clinic of hepatology and gastroenterology in the Ain Shams University hospital and Elqahira Elfatemya hospital. Patients were divided into two equal groups; group A responders to interferon therapy and group B non-responding to Interferon therapy. Patients were subjected to full history taking, clinical examination, laboratory investigations; liver function test, kidney function tests, urine analysis, complete blood count (CBC) , anti-nuclear antibody (ANA), anti-bilharzial antibody, thyroid function tests, viral markers, PCR for HCV, abdominal ultrasound, assessment of visual acuity, fundus examination, assessment of intra-ocular pressure, and liver biopsy. Results: The study included 300 patients; 269 (89.7%) males and 31 (10.3%) females. The mean age of the studied patients was 45.73±5.47. Patients were divided into two equal age and sex matched groups; group A and B. Forty seven (15.7%) developed Retinal complications; 31 patients with cotton wool spots, 3 patients with macular oedema and 13 patient with bilateral retinal exudate. There was no relation between retinal complications and the stage of liver fibrosis by histopathology (X2 =6.29, p=0.179). There was statistical significant relation between retinal complications and liver examination by ultrasonography (X2 =11.92, p=0.003). Conclusion: Fundus examination is recommended in chronic HCV patients on intereferon therapy.