Ocular comorbidities with direct-acting antiviral treatment for chronic hepatitis C virus (HCV) patients

Purpose The aim of this study is to detect the incidence and nature of ocular complications encountered in chronic hepatitis C virus (HCV) patients treated with direct-acting antiviral drugs. Methods This study is a prospective follow-up study on 200 chronic HCV patients attending the Outpatient Hepatology Clinic of National Liver Institute who were indicated for direct-acting antiviral treatment (sofosbuvir, daclatasvir and ribavirin) in the period between January 2017 and December 2017 and referred to the Department of Ophthalmology of Menoufia University hospitals where full ophthalmological examinations were done at the first visit before the treatment, the second visit at the end of the treatment (3 months) and the third visit 3 months later (6 months). Follow-up for those patients was done by slit-lamp examination, IOP measurement by applanation tonometer, colored fundus photographs, fluorescein fundus angiography (FFA), optical coherence tomography. Results Patients who received direct-acting antiviral therapy showed no ocular complications throughout the 6-month period of follow-up. Besides, BCVA and C/D ratio did not show any changes with no statistically significant differences between three visits. No signs of uveitis appeared in patients prescribed to the therapy protocols. Also, FFA did not show any retinal vascular changes. However, two cases of subconjunctival hemorrhage were observed with triple therapy. Conclusion Direct-acting antiviral treatment including sofosbuvir, daclatasvir and ribavirin appears to be safe and shows no detectable intraocular complications in the six-month follow-up period, and routine ophthalmic follow-up seems to be less required than in older anti-HCV medications.