Nicholas J. Butler

Nicholas J. Butler

Johns Hopkins University School of Medicine, USA

Title: Interferon alpha-2b in the treatment of refractory uveitic cystoid macular edema


Nicholas J. Butler, MD completed his medical studies at McGill University in Montreal, Quebec in 2005, followed by residency in ophthalmology at Brown University in Providence, Rhode Island. He spent six months volunteering in Tamil Nadu, India from 2009 to 2010, providing medical and surgical care to indigent patients with eye disease. Upon returning to the U.S., he completed fellowship in uveitis at the Casey Eye Institute in Portland, Oregon in 2011. Currently he is an Assistant Professor of ophthalmology at the Wilmer Eye Institute and is the principal investigator for this site on the MUST-FS.


For patients suffering from uveitis, cystoid macular edema (CME) is a leading cause of vision loss. Depending upon the severity and duration of the CME, the loss of vision may or may not be reversible.
Interferon alphas are a family of cytokines produced by white blood cells which have antiviral, antiproliferative, and immunomodulatory properties. Systemic interferon alpha-2a has demonstrated efficacy in ocular inflammatory disease of non-infectious cause, most notably Behcet’s disease associated uveitis. Increasingly, the efficacy of systemically administered interferon alphas for uveitic CME, both in the setting of active and inactive uveitis, is being elucidated.
The author presents his experience, both published and non-published, with systemic interferon alpha-2b for refractory uveitic CME. The discussion will include a careful analysis of the manifold risks and adverse events associated with interferon alpha-2b and the clinical scenarios in which such a treatment may be considered.

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