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Open Access Case report

Subtenon injection of natural leukocyte interferon α-2a in diabetic macular edema: a case report

Mauro Cellini*, Nicole Balducci, Ernesto Strobbe and Emilio C Campos

Author Affiliations

Department of Specialized, Diagnostic and Experimental Medicine, Ophthalmology Unit, University of Bologna, S. Orsola Malpighi-Hospital, Pelagio Palagi 9, Bologna 40138, Italy

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BMC Ophthalmology 2013, 13:63  doi:10.1186/1471-2415-13-63

Published: 28 October 2013

Abstract

Background

To report the effect of subtenon injections of natural leukocyte interferon α-2a (IFNα) on best corrected visual acuity (BCVA) and central macular thickness (CMT) in a patient with diabetic macular edema (DME).

Case presentation

A 66-year-old man affected by DME, with glycated hemoglobin (HbA1c) at 6.9%, refractory to laser grid treatment and intravitreal injections of triamcinolone, was selected to receive a cycle of three subtenon injections/week of IFNα (1×106 IU/ml). BCVA and CMT, using spectral domain ocular coherence tomography (SD-OCT), were evaluated preoperatively and at 1 week, 1 month, 4 months, and 1 year postoperatively. BCVA and CMT were significantly improved at 1 week after the three injections (20/200 vs. 20/40 and 498 μm vs. 237 μm, respectively). BCVA remained stable during the 1-year follow-up. CMT was slightly increased, but was still lower than the baseline value (215 μm, 255 μm, and 299 μm during the follow-up visits). No adverse events were recorded, with the exception of mild subconjunctival hemorrhage at the injection site.

Conclusions

IFNα, with its immunomodulatory, anti-proliferative and anti-angiogenic actions, was effective in improving BCVA and reducing CMT in refractory DME. Further randomized controlled studies are required to assess the effect of IFNα alone or in combination with other therapies for DME treatment.

Keywords:
Diabetic macular edema; Interferon; Subtenon injections; Central macular thickness; Spectral domain optical coherence tomography