Interferon as a treatment for uveitis associated with multiple sclerosis

Aim: In addition to optic neuritis ( ON), multiple sclerosis ( MS) may also involve the eye with a typically bilateral intermediate uveitis. The aim of this pilot study was to evaluate the efficacy of type I interferons (IFN) for the treatment of MS associated uveitis. Methods: In this non-randomised, retrospective observational case series 13 patients ( eight female, five male) with proved MS and associated uveitis from five uveitis centres who were treated with interferon beta 1a were included. Visual acuity (VA), cell count in the aqueous humour and vitreous, as well as the presence of cystoid macula oedema (CMO) were observed. Results: All except one patient had a bilateral form of intermediate uveitis ( total of 24 eyes). Seven patients had documented CMO before IFN treatment (n = 13 eyes). Median duration of treatment was 24.6 months ( range 7.9 - 78.7). VA improved in 17 eyes ( comparing VA before therapy and at last follow up); while 10 eyes (36%) improved >= 3 Snellen lines. Aqueous cell count improved by 1.2 (SD 1.1) grades in all eyes. Vitreous cell count improved by 1.7 (1.4) in all eyes. Only two patients still had minimal CMO on last follow up angiographically. CMO resolved after or during IFN treatment in nine eyes. Conclusions: IFN has been shown to have beneficial effects in patients with MS and/or ON. As shown in the models of experimental allergic encephalomyelitis (EAE) and uveitis, the neurological and ophthalmological manifestations seem to share similar pathogenic mechanisms. Treatment of MS associated uveitis with IFN appears to have beneficial effects on VA, intraocular inflammation activity, and the presence of CMO.