Paclitaxel‐induced cystoid macular oedema

Chang, Shin-Yu; Tsai, Shih‐Wei; Chen, Lee-Jen; Chan, Wei-Chun

doi:10.1111/aos.13219

Cited by 10 publications

(7 citation statements)

References 5 publications

(12 reference statements)

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“…8,9 The differential diagnosis of cystoid macular edema without (or minimal) fluorescein leakage includes Goldmann-Favre syndrome, niacin maculopathy, juvenile X-linked retinoschisis and some subtypes of retinitis pigmentosa. 10 Taxane-related macular edema is usually bilateral and the time interval from exposure to clinical presentation can range from a few months to about 2.5 years. 8,11 The pathophysiology of this taxane-related maculopathy is still unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Other possible explanations could be the leakage of molecules smaller than fluorescein (or at a slow leaking rate) not detected by conventional fluorescein angiography. 10,12,13 Drug discontinuation is the appropriate management of this condition and macular edema is usually reversible upon drug discontinuation. 8 Visual acuity frequently improves with resolution of macular edema, but the length of treatment and duration of edema can influence visual outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Use of topical (and sub-tenon or intravitreal) corticosteroids, non-steroidal anti-inflammatory drugs and carbonic anhydrase inhibitors have been described with little or no efficacy. 10,12 Taxanes may be associated, in very rare cases, with the development of reversible macular edema. Clinicians, especially oncologists and ophthalmologists, should be aware of this potential side effect in order to better diagnose and treat this condition.…”

Section: Discussionmentioning

confidence: 99%

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Macular Cystoid Edema Induced by Nab-Paclitaxel

Pereira¹,

Vale²,

Moreira³

et al. 2022

Acta Med Port

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A 61-year old male was referred to the Ophthalmology department because of decreased bilateral visual acuity. The patient had metastatic pancreatic adenocarcinoma and was being treated with gemcitabine+nab-paclitaxel. On examination, the patient presented best corrected visual acuities of 4/20 and 2/20 in the right and left eye, respectively. The optical coherence tomography revealed bilateral severe macular edema. Macular edema was considered secondary to nab-paclitaxel and the drug was discontinued. Three months after drug discontinuation, the patient presented best corrected visual acuities of 20/20 and 16/20 in the right and left eye, respectively, and normal fundoscopy. Macular edema is a very rare side effect of taxanes, and the etiopathology is still unknown. Edema is usually reversible upon discontinuation of the offending agent. Clinicians should be aware of this adverse effect of taxanes, and a high index of clinical suspicion is essential for diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Macular Cystoid Edema Induced by Nab-Paclitaxel

Pereira¹,

Vale²,

Moreira³

et al. 2022

Acta Med Port

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“…The mechanism of toxicity is unclear but speculated theories include dysfunction of Muller cells and subclinical extracellular fluid leakage. 358,359…”

Section: Pathophysiologymentioning

confidence: 99%

The Impact of Systemic Medications on Retinal Function

Somisetty

Santina

Sarraf

et al. 2023

Asia-Pacific Journal of Ophthalmology

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This study will provide a thorough review of systemic (and select intravitreal) medications, along with illicit drugs that are capable of causing various patterns of retinal toxicity. The diagnosis is established by taking a thorough medication and drug history, and then by pattern recognition of the clinical retinal changes and multimodal imaging features. Examples of all of these types of toxicity will be thoroughly reviewed, including agents that cause retinal pigment epithelial disruption (hydroxychloroquine, thioridazine, pentosan polysulfate sodium, dideoxyinosine), retinal vascular occlusion (quinine, oral contraceptives), cystoid macular edema/retinal edema (nicotinic acid, sulfa-containing medications, taxels, glitazones), crystalline deposition (tamoxifen, canthaxanthin, methoxyflurane), uveitis, miscellaneous, and subjective visual symptoms (digoxin, sildenafil). The impact of newer chemotherapeutics and immunotherapeutics (tyrosine kinase inhibitor, mitogen-activated protein kinase kinase, checkpoint, anaplastic lymphoma kinase, extracellular signal-regulated kinase inhibitors, and others), will also be thoroughly reviewed. The mechanism of action will be explored in detail when known. When applicable, preventive measures will be discussed, and treatment will be reviewed. Illicit drugs (cannabinoids, cocaine, heroin, methamphetamine, alkyl nitrite), will also be reviewed in terms of the potential impact on retinal function.

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“…The reported incidence rate range from 0.198% to 0.5% ( 2 , 3 ). The onset of CME varies from two months to a half years after taxane administration ( 4 ). Taxane-related CME is a self-limiting disease recovered after cessation of taxane treatment.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Intravitreal dexamethasone implant as adjuvant treatment for taxane-related cystoid macular edema

Liu

Ding²,

Lin³

2022

Front. Ophthalmol.

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Taxane-related cystoid macular edema (CME) is a rare complication of the taxoid medication, a chemotherapeutic drug. We report a 47-year-old Han Chinese man referred to our Eye Center for decreased vision with visual distortion in both eyes for two weeks. Two weeks prior, he received the last cycle of his six-monthly chemotherapy, including paclitaxel for hypopharyngeal malignancy. The best-corrected visual acuity (BCVA) was 0.4 OD and 0.1 OS. Macular optical coherence tomography showed significant bilateral CME, and fluorescein angiography (FA) revealed the fluorescein pooling at the late phase without leakage. Intravitreal 700 μg dexamethasone (DEX) implant was applied to the left eye and 13 days after to the right eye. Two months later, the macular morphology recovered to normal. One year after the first visit, the BCVA was 1.0 OD and 0.8 OS with standard macula on OCT. In conclusion, the intravitreal DEX implant might be an effective adjuvant treatment for taxane-related CME.

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Paclitaxel‐induced cystoid macular oedema

Cited by 10 publications

References 5 publications

Macular Cystoid Edema Induced by Nab-Paclitaxel

Macular Cystoid Edema Induced by Nab-Paclitaxel

The Impact of Systemic Medications on Retinal Function

Case Report: Intravitreal dexamethasone implant as adjuvant treatment for taxane-related cystoid macular edema

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