Subconjunctival interferon α-2a application in a case wıth serpiginous choroidopathy.

Abstract

Serpiginous choroidopathy (SC) is a chronic, inflammatory disease which progresses with recurrences leading to visual loss. Diverse immunosuppressive regimens have been used for treatment. In case of an unanticipated side effect with immunosuppressive agents, alternative modalities in SC are limited. A 38-year-old woman presented with slight deterioration in visual acuity in her right eye. She had had a visually devastating episode of SC in the left eye 8 months previously. She received combination therapy of prednisone, cyclosporine, and intravitreal triamcinolone for the left eye. With that treatment, vision in her left eye declined to light perception due to macular involvement and renal functions were impaired. Eight months later, she was hospitalized with the diagnosis of SC in the right eye. In the quest for an alternative modality, a combination of antituberculosis medications was given initially, because of the high PPD reading. Despite 10 days of treatment, the lesion persistently progressed. Subsequently, interferon (INF) α-2a therapy was initiated solely as daily injections of 1 million unit (MIU) subconjunctivally. The frequency of injections was tapered within the course. Currently, injections are still being dispensed once a month. Throughout the 12 months of follow-up, the patient had no major side effects due to INF α-2a therapy. At present, SC in the right eye is inactive and the macula is safe in terms of incurring. The vision is 20/20 in the right eye, whereas it is light perception in the left eye. Interferon α-2a administration in SC can be an efficient modality and is free of immunosuppression related side effects. Subconjunctival application seems to be a promising and safe tool for treatment.