similar type of optic nerve damage

[johnnyd53830]

L am a 62 yeqr old male , who has lost most of my vision from damage to my optic nerves.  The damage occured approximatrly two years ago after receiving treatment for Melanoma.  The protocol called for treatment with Interferon, infusion each day for amonth  and self injections for an elven month period.  Within five weeks of treatment I began to exeperince eye trouble and now have almost no vision (this forim is difficult for me to use). I guess my current diagnosis is optic neuropathy.  I am interested if any else has had any similar experience ?  Iwas in excellent health prior to my cancer treatment  (avud  runner 6 miles per day) with really no medical history or eye problems other than glasses

[John C Hagan III, MD, FACS, FAAO]

For a number of reasons:
1. The USA is awash in trial lawyers and lawsuits. You can't even get through watching the evening news without 3-5 commercials by trial lawyers soliciting lawsuits against doctors, hospitals or drug companies. So an eye exam before during and after is partially "defensive medicine"
2. Because often these medications are used in patients that might have or develop MS and they may not be aware of pre-existing MS related damage and attribute it to later treatment.
3. Because the eye exam by an Eye MD may help with the diagnosis in difficult cases.
4. Because melanoma can either start in the eye (its the most common primary malignant intraocular tumor) or melanoma elsewhere as the primary can spread into the eye.
5. Because any patient taken care of by MDs that complains of visual changes is referred to an Eye MD.

As I said good luck with your therapy and do read up on the cardiovascular damage that can be caused by endurance aerobic exercise done greater than an hour. Lightening can strike twice.

JCH MD

[johnnyd53830]

Dr. Hagen, Again thank you for responding to my inquiry.  So it is now my understanding that the odds of toxic optic neuropathy  from the use of interferon ar3e similiar  to the odds of dying in a car accident or plane crash.   My only issue with this, is why does some of the lierature associated with the use of interferon suggest an eye exam prior to infusion.  Again thank you for your help

[johnnyd53830]

DR. thank you  for your comments they are truly appreciated, however I think you are missing my question and point of my inquiry.  I made the point of running and execirse only to provide information as to my overall state of heaLth.  At  59  years old when I was diaginosd with melanoma I was in excellent condition, no physical problems or prescriptions of any type.  If I had been aware that this was a side effect of interferon I would have treated this diease in a different manner.  I am well aware of many side effects of many drugs, having exeperienced many through my treatments for cancer and my eyes.  However my question remains - Is optic nerve damage a sifnifcant risk  with treatment with interferon and has it happen to others?  The treatment appears worse than the diease.  I have been to no fewer than 5 neuro opthamologists without a clear anwser

[John C Hagan III, MD, FACS, FAAO]

You can do a literature search but the relationship of interferon use and optic neuropathy was listed as "possible" not definite last time I looked. You have a disease that is potentially fatal, all medications can have side effects. The more serious the disease generally the more severe side effects.  A 100% effective medication with 0% side effects does not exist and will not be likely in the next 10-20 years.

I am a former marathon runner, triathalon (Half Iron Man's), long distance bike runner. You should know that a number of papers including a recent one in the Mayo Clinic Proceedings have implicated long term, maximum effort aerobic exercise in excess of one hour with heart disease and elevated Heart CT coronary artery calcium scores. Also some studies suggest a higher than normal rate of cancer and malignant disease. You can easily pull these papers up using any search engine.

http://peakperformance.runnersworld.com/2012/06/q-a-with-the-potential-adverse-effects-of-endurance-exercise-authors/

If you did much of your running outside with inadequate protection from the sun that dramatically increases the risk of skin melanoma.

You should consider seeing a neuro-ophthalmologist, concentrating on keeping your remaining eye free of disease, injury and have it examined regularly.

Good luck.

JCH MD