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Pharmacoepidemiol Drug Saf. 2018 Feb;27(2):191-198. doi: 10.1002/pds.4363. Epub 2017 Dec 6.

Retinal vascular complications associated with interferon-ribavirin therapy for chronic hepatitis C: A population-based study.

Lai CH1,2,3,4, Yang YH4,5,6,7, Chen PC7,8, King YC1, Liu CY6.

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Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.
Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.



To investigate the incidence of retinal vascular complications and risk factors in patients with chronic hepatitis C receiving interferon-ribavirin therapy in Taiwan.


By using the Taiwan National Health Insurance Research Database, we compared the incidence of retinal vascular complications between patients receiving and not receiving interferon-ribavirin treatment. The exposure and nonexposure groups were randomly 1:1 frequency-matched according to age, sex, income, urbanization level, hypertension, and diabetes. Incidence of each retinal vascular complication and hazard ratios were assessed in the follow-up evaluation.


Of the sample of 4736 patients, a total of 182 patients (3.84%) developed retinopathy during the follow-up period, of which 110 patients (4.65%) received interferon-ribavirin therapy and 72 patients (3.04%) did not receive interferon-ribavirin therapy. After multivariate adjustments, the risk of retinopathy during the follow-up period was 1.533 (95% confidence interval [CI], 1.139-2.064; P = .0048) times higher in patients receiving interferon-ribavirin therapy than in those in the comparison cohort not receiving the therapy. Patients with hypertension compared with those without it (adjusted hazard ratio, 1.530; 95% CI, 1.069-2.135; P = .0125) also had an increased risk of retinopathy.


Interferon-ribavirin therapy was associated with a 53.3% increased risk of retinal vascular complications compared with not receiving the therapy. Regular ophthalmologic examination is essential for patients receiving interferon-ribavirin, particularly those with hypertension.


cotton-wool spots; hepatitis C virus; interferon; pharmacoepidemiology; retinal hemorrhage; retinal vascular complication

[Indexed for MEDLINE]

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