Bilateral cystoid macular edema following docetaxel chemotherapy in a patient with retinitis pigmentosa: a case report

Abstract

BackgroundDocetaxel is a chemotherapeutic agent of the taxane class of drugs for the treatment of breast cancer. We present a female patient who noted decreased vision after docetaxel treatment.Case presentationA 45-year-old female patient received docetaxel treatment after resection of a breast carcinoma. Funduscopy and optical coherence tomography (OCT) showed cystoid macular edema on both eyes. Dilated funduscopy also showed bone spicule-like pigmented deposits, typical for retinitis pigmentosa. Besides the fundus appearance restricted peripheral vision and scotopic electroretinogram confirmed the diagnosis of retinitis pigmentosa. Chemotherapy was discontinued following a consulation with the oncologist of the patient. After five weeks, visual acuity improved significantly along with decrease of retinal thickness measured by OCT.ConclusionDocetaxel may cause ocular adverse effects such as cystoid macular edema. Ophthalmological examination is warranted for patients with visual complaints during docetaxel chemotherapy.

Cystoid Macular Edema during Treatment with Paclitaxel and Bevacizumab in a Patient with Metastatic Breast Cancer: A Case Report and Literature Review

“…The treatment was changed from paclitaxel to capecitabine, and 6 weeks after discontinuing paclitaxel the patient's visual symptoms recovered, and fundus examination and OCT scans revealed resolution of CME. Four cases of CME associated with docetaxel therapy were documented [ 4 , 5 , 6 ]. Two authors reported CME due to albumin-bound paclitaxel, with resolution on discontinuation of the drug [ 7 , 8 ].…”

“…CME can also be caused by various drugs such as taxanes, thiazolizine, tamoxifen, niacin, interferon, fingolimod, prostaglandin, epinephrine, timolol, and others. In taxanes, paclitaxel is commonly reported [ 1 , 9 , 13 ], followed by nanoparticle albumin-bound paclitaxel [ 7 , 8 ] and docetaxel [ 4 , 5 , 6 , 14 ].…”

Docetaxel-induced maculopathy possibly potentiated by concurrent hydroxychloroquine use

“…Taxane-induced CME has been reported with 4 cases involving docetaxel,2, 3, 4, 5 but previous case reports have been clouded by the concurrent use of other agents (such as tamoxiphen) or conditions (retinitis pigmentosa or the fluid retention syndrome) also known to cause CME. This has led some to hypothesize that taxanes might potentiate the tendency towards CME in such settings 4 , 5 . Generally, the CME resolved with cessation of the drug, although in some cases topical or oral acetazolamide was also used 2 , 6 .…”

Docetaxel Retinopathy: A Case Report

“…On the other hand, 3 cases [ 8 ] of CME without fluorescein leakage secondary to docetaxel administration have been reported. In 2 out of the 3 cases, the toxicity of docetaxel has been associated either with retinopathy pigmentosa [ 9 ] or with fluid retention syndrome [ 10 ]. In our case, the combined use of tamoxifen could have potentiated the toxic effect of docetaxel on the macula.…”