Ultra-widefield angiographic imaging of albumin-bound paclitaxel-induced cystoid macular edema

Cystoid Macular Edema following Treatment with Nanoparticle Albumin-Bound Paclitaxel and Atezolizumab for Metastatic Breast Cancer

“…CME is seen in various pathologies and diseases through fluorescence leakage, generally observed on fluorescein fluorescence fundus angiography due to disruption of the medial vascular retinal barrier and leakage of fluorescein out of the retinal vessels. However, CME caused by taxane-based anticancer drugs is thought to be due to toxicity to Müller cells and fluorescence leakage or fluorescence retention tends not to be observed with OCT [ 7 ]. It is assumed that the toxic taxane drugs cause intracellular fluid retention and an increase in extracellular fluid in Müller cells, resulting in the disruption of the intracellular structure of Müller cells and the formation of cysts in the outer reticular and inner granular layers, leading to the formation of CME [ 8 ].…”

Intravitreal Ranibizumab Had Limited Effect on Cystoid Macular Edema Due to Albumin-Bound Paclitaxel: A Case Report and Literature Review

“…It has been reported that, in 97.83% of the cases, no leakage was detected in fundus fluorescence angiography (FFA) or significant ICGA changes ( 20 , 31 ). In all T-CME cases listed here (literature review and case report), which resulted from albumin-bound paclitaxel, no or minimal leakage was identified by FFA.…”

“…Concerning treatment, the literature reviewed showed that some T-CME cases spontaneously resolved after discontinuing nab-paclitaxel without eye treatment within 1.5 weeks to 6 months (5,6,(9)(10)(11)(12)(13)(19)(20)(21). Though the mechanism of inflammatory factors is uncertain, anti-inflammatory agents (steroids or NSAIDs) were applied previously.…”

“…In these cases, the male to female ratio was 1:2.8, the mean age was 60 years (32-73 years), and almost all had bilateral eyes involvement except one. Fourteen cases were diagnosed with breast cancer (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)24), six with pancreatic cancer (19)(20)(21)(22)(23)(24), and the others with melanoma (5), cancer of the hypopharynx ( 18), and lung cancer (6), respectively. The treatment regimens were heterogeneous, with most patients discontinuing nab-paclitaxel with or without eye treatments, including topical nonsteroidal anti-inflammatory drugs (NSAIDs), topical corticosteroids, topical dorzolamide (DRZ), intravitreal bevacizumab (IVB), dexamethasone.…”