Impaired retinal pigment epithelium in paclitaxel-induced macular edema: A case report

RATIONALE: Cystoid macular edema (CME) is a rare complication of the paclitaxel. However, the pathophysiology was unknown. PATIENT CONCERNS: A 60-year-old female presented with bilateral blurred vision due to cystoid macular edema after taking 12-course paclitaxel for her breast cancer. Optical cohe...

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Detalles Bibliográficos
Autores principales: Shih, Chia-Hsin, Lee, Yuan-Chieh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Research Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039693/
https://www.ncbi.nlm.nih.gov/pubmed/29952984
http://dx.doi.org/10.1097/MD.0000000000011229
Descripción
Sumario:RATIONALE: Cystoid macular edema (CME) is a rare complication of the paclitaxel. However, the pathophysiology was unknown. PATIENT CONCERNS: A 60-year-old female presented with bilateral blurred vision due to cystoid macular edema after taking 12-course paclitaxel for her breast cancer. Optical coherence tomography (OCT), fluorescein angiography (FAG), indocyanine green angiography (ICGA), electroretinogram (ERG) and electrooculogram (EOG) were performed. DIAGNOSES: Paclitaxel-induced macular edema. INTERVENTIONS: Paclitaxel was discontinued and supportive treatment with pentoxifylline was given. OUTCOMES: The OCT showed bilateral cystoid macular edema. Impaired filling of choriocapillaries was noted on the ICGA; while EOG revealed decreased Arden ratio. The visual acuity, cystoid macular edema and decreased Arden ratio improved slowly over six months. LESSONS: Paclitaxel rarely causes cystoid macular edema. The damage of choriocapillaries and retinal pigment epithelium might be the underlying cause. Immediate discontinuation of the drug helps visual recovery.

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