الفهرس 
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Abstract
Egypt has possibly the highest HCV prevalence in the world,10%-20% of the general population is infected and HCV is the leading cause of chronic liver disease and HCC in the country.
The main treatment for this intractable disease in interferon therapy. Published guidelines recommend interferon-ribavirin combination as a first-line treatment.
Interferon associated retinopathy was first described in 1990.
The spectrum of ocular complications associated with PEGINFα therapy for chronic hepatitis C is broad. The most common manifestation of ocular toxicity is retinopathy, mainly cotton wool spots and/or retinal hemorrhage.
The incidence of retinopathy with INF therapy was reported to be 18-86%, and patients developed retinopathy from 2 weeks and months from the beginning of treatment, but most frequently between 4 and 12 weeks.
Reported risk factors for interferon retinopathy include hypertension, diabetes mellitus and high interferon dosages as both hypertension and diabetes disrupt retinal microcirculation.
The exact mechanism of interferon-induced-retinopathy is not known, but it could be related to the deposition of immune complexes in the retinal vasculature, leading to leukocyte infiltration and occlusion of retinal capillaries with retinal ischemia which leads to the formation of cotton wool spots.
The retinopathy is generally mild, most frequently asymptomatic and usually resolves completely during therapy or quickly after therapy.
Although rare, several other atypical interferon-associated ocular complications have been reported, such as cystoid macular oedema, anterior ischemic optic neuropathy, retinal vein thrombosis optic disc oedema, neovascular glaucoma and peri-phlebitis.
Pretreatment and subsequent eye examination while on treatment may not to be necessary in asymptomatic patients, although some recommend regular screening because of the rare incidence of severe visual complications, for visually symptomatic patients and for high risk patients with a history of diabetes or hypertension.