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Naseripour M, Hemmati S, Chaibakhsh S, Gordiz A, Miri L, Abdi F. Cystoid macular oedema without leakage in fluorescein angiography: a literature review. Eye (Lond) 2023; 37:1519-1526. [PMID: 36088420 PMCID: PMC10219944 DOI: 10.1038/s41433-022-02230-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/21/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022] Open
Abstract
Cystoid macular oedema (CMO), which is defined as a macular thickening and cystic changes due to accumulation of fluid, could be asymptomatic and only diagnosed using paraclinical techniques. Fluorescein angiography (FA) and optical coherence tomography (OCT) are useful in detecting CMO in clinical practice. Non-leaking CMO, also known as angiographically silent CMO, is referred to as cases of CMO without leakage in fluorescein angiography. This type of CMO has been reported in some retinal dystrophies, in cases of maculopathy as a side effect of certain drugs, and also in some systemic disorders. The exact mechanism and treatment options for this type of CMO are still not clear. This literature review aims to discuss different causes of non-leaking CMO, proposed mechanisms, and management options. Three sections including drugs, retinal dystrophies, and systemic disorders are discussed in this review.
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Affiliation(s)
- Masood Naseripour
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Hemmati
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Chaibakhsh
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Arzhang Gordiz
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Miri
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
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2
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Stache N, Bohn S, Sperlich K, George C, Winter K, Schaub F, Do HV, Röhlig M, Reichert KM, Allgeier S, Stachs O, Stachs A, Sterenczak KA. Taxane-Induced Neuropathy and Its Ocular Effects-A Longitudinal Follow-up Study in Breast Cancer Patients. Cancers (Basel) 2023; 15:cancers15092444. [PMID: 37173911 PMCID: PMC10177451 DOI: 10.3390/cancers15092444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
A common severe neurotoxic side effect of breast cancer (BC) therapy is chemotherapy-induced peripheral neuropathy (CIPN) and intervention is highly needed for the detection, prevention, and treatment of CIPN at an early stage. As the eye is susceptible to neurotoxic stimuli, the present study aims to determine whether CIPN signs in paclitaxel-treated BC patients correlate with ocular changes by applying advanced non-invasive biophotonic in vivo imaging. Patients (n = 14, 10 controls) underwent monitoring sessions after diagnosis, during, and after therapy (T0-T3). Monitoring sessions included general anamnesis, assessment of their quality of life, neurological scores, ophthalmological status, macular optical coherence tomography (OCT), and imaging of their subbasal nerve plexus (SNP) by large-area confocal laser-scanning microscopy (CLSM). At T0, no significant differences were detected between patients and controls. During treatment, patients' scores significantly changed while the greatest differences were found between T0 and T3. None of the patients developed severe CIPN but retinal thickenings could be detected. CLSM revealed large SNP mosaics with identical areas while corneal nerves remained stable. The study represents the first longitudinal study combining oncological examinations with advanced biophotonic imaging techniques, demonstrating a powerful tool for the objective assessment of the severity of neurotoxic events with ocular structures acting as potential biomarkers.
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Affiliation(s)
- Nadine Stache
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department of Obstetrics and Gynecology, Rostock University Medical Center, 18059 Rostock, Germany
| | - Sebastian Bohn
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University Rostock, 18059 Rostock, Germany
| | - Karsten Sperlich
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University Rostock, 18059 Rostock, Germany
| | - Christian George
- Department of Obstetrics and Gynecology, Rostock University Medical Center, 18059 Rostock, Germany
| | - Karsten Winter
- Institute of Anatomy, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Friederike Schaub
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
| | - Ha-Vy Do
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
| | - Martin Röhlig
- Institute for Visual and Analytic Computing, University of Rostock, 18059 Rostock, Germany
| | - Klaus-Martin Reichert
- Institute for Automation and Applied Informatics, Karlsruhe Institute of Technology, 76344 Eggenstein-Leopoldshafen, Germany
| | - Stephan Allgeier
- Institute for Automation and Applied Informatics, Karlsruhe Institute of Technology, 76344 Eggenstein-Leopoldshafen, Germany
| | - Oliver Stachs
- Department of Ophthalmology, Rostock University Medical Center, 18057 Rostock, Germany
- Department Life, Light & Matter, University Rostock, 18059 Rostock, Germany
| | - Angrit Stachs
- Department of Obstetrics and Gynecology, Rostock University Medical Center, 18059 Rostock, Germany
| | - Katharina A Sterenczak
- Department of Obstetrics and Gynecology, Rostock University Medical Center, 18059 Rostock, Germany
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3
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Güven YZ, Akbalık T. A novel therapy in paclitaxel-related cystoid macular edema: Brimonidine. J Fr Ophtalmol 2023; 46:e154-e156. [PMID: 36828725 DOI: 10.1016/j.jfo.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 02/24/2023]
Affiliation(s)
- Y Z Güven
- İzmir Katip Çelebi University Atatürk Educating and Research Hospital, Department of Ophthalmology, İzmir, Turkey.
| | - T Akbalık
- İzmir Katip Çelebi University Atatürk Educating and Research Hospital, Department of Ophthalmology, İzmir, Turkey
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4
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Toxische Retinopathien. Ophthalmologe 2020; 117:1247-1266. [DOI: 10.1007/s00347-020-01260-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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5
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Álvarez-Fernández D, Cubillas-Martín M, Álvarez-Suárez ML, Viescas-Fernández MJ, Medina-Mejías MR, Rodríguez-Balsera C. Macular oedema associated with taxanes: A case report and literature review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2020; 95:485-495. [PMID: 32600835 DOI: 10.1016/j.oftal.2020.05.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Although taxanes are a frequently used group of chemotherapy agents, they can, rarely, lead to macular oedema. The purpose of this article is to review and communicate, in an integrated way, the data of the cases previously reported in the literature, as well as to present a new case. MATERIAL AND METHODS Narrative review of reports of cases of macular oedema associated with taxanes, and communication of the clinical case of a 73-year-old woman who, after treatment with paclitaxel for metastatic breast cancer, developed macular oedema that disappeared after discontinuing the drug. RESULTS The review included 57 cases with data from 109 eyes collected in 52 articles. The large majority (76.79%) of the cases were women, and the mean age was 58.75 years. The cancer that most frequently motivated the treatment was breast cancer (60.72%), and 92.5% of cases had metastases. The most frequently associated drug was paclitaxel (52.63%). The median time to symptom development was 4.25 months. At the initial examination, 92.86% of the cases had bilateral oedema and the mean visual acuity was 0.4 (decimal scale). The mean macular thickness was 509.63 microns, and 97.83% of the eyes had no or minimal angiographic findings. In 90.57% of the cases, the treatment with taxanes was interrupted, and some other treatment was used in 43.86% of the cases, with the most widely used being acetazolamide. The outcome was favourable, to a greater or lesser extent, in 96.23% of cases. CONCLUSIONS Despite being a rare entity, macular oedema associated with the use of taxanes is a disorder that every oncologist and ophthalmologist should be aware of, taking into account the good outcome of the condition that usually occurs when treatment is suspended.
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Affiliation(s)
- D Álvarez-Fernández
- Hospital Vital Álvarez Buylla, Santuyano, Mieres, Principado de Asturias, España.
| | - M Cubillas-Martín
- Hospital Vital Álvarez Buylla, Santuyano, Mieres, Principado de Asturias, España
| | - M L Álvarez-Suárez
- Hospital Vital Álvarez Buylla, Santuyano, Mieres, Principado de Asturias, España
| | | | - M R Medina-Mejías
- Hospital Vital Álvarez Buylla, Santuyano, Mieres, Principado de Asturias, España
| | - C Rodríguez-Balsera
- Hospital Vital Álvarez Buylla, Santuyano, Mieres, Principado de Asturias, España
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Kaya M, Atas F, Gulsum Guc Z, Oztop I, Durak I, Saatci AO. A cross-sectional optical coherence tomography study in patients on taxane-based therapy and a case report with the literature review. Cutan Ocul Toxicol 2020; 39:287-293. [DOI: 10.1080/15569527.2020.1790592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mahmut Kaya
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ferdane Atas
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Zeynep Gulsum Guc
- Department of Medical Oncology, Izmir Katip Celebi University, Izmir, Turkey
| | - Ilhan Oztop
- Department of Medical Oncology, Institute of Oncology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ismet Durak
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ali Osman Saatci
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Optical coherence tomography characteristics of taxane-induced macular edema and other multimodal imaging findings. Graefes Arch Clin Exp Ophthalmol 2020; 258:1607-1615. [DOI: 10.1007/s00417-020-04755-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022] Open
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Anderson DE, Holstein SA, Kedar S. Visual Pathway Degeneration in Chemotherapy-Related Neurotoxicity: A Review and Directions for Future Research. Neuroophthalmology 2020; 44:139-147. [PMID: 32395165 DOI: 10.1080/01658107.2019.1702703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022] Open
Abstract
Chemotherapy-related neurotoxicity (CRNT) is an emerging public health concern. Visual pathway degeneration may be a symptom of CRNT. We surveyed the current literature for evidence of visual pathway degeneration in cancer patients receiving chemotherapy. A systematic review was conducted in PubMed. Six published articles met our inclusion criteria. The studies showed reduced retinal thickness, primarily in the retinal nerve fibre layer, and impaired inner retinal function in patients receiving chemotherapy. In summary, the current literature suggests chemotherapy may induce visual pathway degeneration. Future research may benefit from improving study design, exploring mechanisms of chemotherapy-related visual pathway degeneration, and incorporating these findings into biomarker development.
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Affiliation(s)
- David E Anderson
- Department of Ophthalmology & Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sarah A Holstein
- Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Division of Hematology & Oncology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sachin Kedar
- Department of Ophthalmology & Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Burgos-Blasco B, Hernandez-Ruiz S, Lopez-Guajardo L, Donate-Lopez J. Dexamethasone intravitreal implant in cystoid macular edema secondary to paclitaxel therapy. Am J Ophthalmol Case Rep 2020; 18:100653. [PMID: 32190783 PMCID: PMC7068047 DOI: 10.1016/j.ajoc.2020.100653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/08/2019] [Accepted: 03/04/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose To report the first case of cystoid macular edema (CME) induced by nabpaclitaxel treated with intravitreal dexamethasone implant. Observations A 67 year-old man diagnosed with unresectable pancreatic cancer presented with decreased vision in both eyes while receiving nab-paclitaxel. He was diagnosed with CME and intravitreal dexamethasone implants were administered in both eyes. Central retinal thickness (CRT) of both eye decreased 1 month after the implant but CME persisted. 2 months after Ozurdex implant nabpaclitaxel was discontinued, improving central macular thickness and the CME significantly in both eyes. Conclusion and importance Cessation of nab-paclitaxel could lead to resolution of CME more than intravitreal dexamethasone implant, although intravitreal dexamethasone implant achieved some reduction in central macular thickness.
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Affiliation(s)
| | | | | | - Juan Donate-Lopez
- Ophthalmology Department, Hospital Clinico San Carlos, Madrid, Spain
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Noguchi Y, Kawashima Y, Maruyama M, Kawara H, Tokuyama Y, Uchiyama K, Shimizu Y. Current status of eye disorders caused by docetaxel administration every 3 weeks: A case-control study in Japanese patients. J Oncol Pharm Pract 2019; 26:655-665. [PMID: 31446870 DOI: 10.1177/1078155219868761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Docetaxel is known to cause eye disorders. In this study, current status of eye disorders caused by docetaxel administration every 3 weeks in Japanese patients was examined. METHODS This case-control study targeted patients who were newly administered docetaxel at the Kyoto Okamoto Memorial Hospital between 1 July 2015 and 30 June 2018. Eye disorder occurrence was defined as an event in which the pharmacist confirmed the symptoms in a patient interview and the ophthalmologist diagnosed the disorder. RESULTS Of the 89 subjects, 7 (7.9%) had eye disorders. The symptoms were watering eyes (7.9%), a stye and eye discharge (2.2% each), corneal and conjunctival disorder, visual acuity reduction, and blepharedema (1.1% each). Four patients who presented with watering eyes, eye discharge, or corneal and conjunctival disorder showed improvement with the use of eye drops such as artificial tears. Two patients who presented with a stye showed improvement with the use of oral cefcapene. One patient with mild symptoms showed spontaneous improvement. However, one patient had irreversible visual acuity reduction. The multivariate logistic regression analysis revealed that a cumulative docetaxel dose of ≥300 mg/m2 (odds ratio: 15.50, 95% confidence interval: 1.37-175.00, p = 0.027) and concomitant cyclophosphamide use (odds ratio: 13.20, 95% confidence interval: 1.13-153.00, p = 0.039) were significant risk factors associated with eye disorders. CONCLUSION In conclusion, it was determined that docetaxel-related eye disorders might be influenced by the cumulative dose of docetaxel and concomitant cyclophosphamide use. In addition, relatively mild symptoms improved with medication.
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Affiliation(s)
- Yusuke Noguchi
- Department of Pharmacy, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kuse-gun, Kyoto, Japan.,Department of Pharmacy, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Yugo Kawashima
- Department of Pharmacy, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kuse-gun, Kyoto, Japan
| | - Megumi Maruyama
- Department of Pharmacy, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kuse-gun, Kyoto, Japan
| | - Hiroko Kawara
- Department of Pharmacy, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kuse-gun, Kyoto, Japan
| | - Yoko Tokuyama
- Department of Pharmacy, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kuse-gun, Kyoto, Japan
| | - Kiyoshi Uchiyama
- Department of Digestive Surgery, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kuse-gun, Kyoto, Japan.,Department of Surgery, Rakuwakai Marutamachi Hospital, Kyoto, Japan
| | - Yoshihiro Shimizu
- Department of Digestive Surgery, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kuse-gun, Kyoto, Japan
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Kanakis M, Georgalas I, Makatsoris T, Pharmakakis N. Taxane Induced Cystoid Macular Edema: Case Report and Integrated Pathogenic Theory. Curr Drug Saf 2019; 14:43-47. [PMID: 30156164 DOI: 10.2174/1574886313666180828163016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE To report a case of a 73-year-old man who presented with decreased visual acuity due to bilateral macular edema after paclitaxel administration for prostate cancer. METHODS The ophthalmic evaluation consisted of medical and ocular history, Best Corrected Visual Acuity, slit-lamp biomicroscopy and Spectral-domain optical coherence tomography / Fluorescein Angiography. RESULTS Optical Coherence Tomography and Fluorescein Angiography revealed silent cystoid macular edema. After consulting with the oncologist, the cessation of paclitaxel therapy was decided. The patient presented a gradual but steady resumption of the retinal edema, with complete restoration of normal retinal morphology and function within two months. The pathogenesis of the silent Cystoid Macular Edema (CME) is still unclear. Based on our case and a critical review of the previous observations and published data, we propose that the underlying cause of Taxane induced CME is the functional failure of Aquaporin mediated water transport at the level of retinal Intermediate and Deep capillary plexuses, and at lesser extent at the level of the Retinal Pigment Epithelium. CONCLUSION Taxane induced silent CME should be attributed to the action of Taxanes on the microtubule guided aquaporin vesicles transport to the cell membrane. In our case of Taxane induced silent CME, withdrawal of the taxane was enough for complete recovery, and no additional treatment was needed.
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Affiliation(s)
- M Kanakis
- University of Patras, Medical School, University Eye Clinic, Rion University Hospital, Patras, Greece
| | - I Georgalas
- University of Athens, Medical School, 1st University Eye Clinic, G. Genimatas General Hospital, Athens, Greece
| | - T Makatsoris
- Department of Medicine, Division of Oncology, University of Patras, Medical School, Rion University Hospital, Patras, Greece
| | - N Pharmakakis
- University of Patras, Medical School, University Eye Clinic, Rion University Hospital, Patras, Greece
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