Mesquida Marina, Sanchez-Dalmau Bernardo, Ortiz-Perez Santiago, Pelegrín Laura, Molina-Fernandez Juan José, Figueras-Roca Marc, Casaroli-Marano Ricardo, Adán Alfredo
Ophthalmology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.
Case Rep Oncol. 2010 Nov 22;3(3):423-427. doi: 10.1159/000322675.
We report the case of a 52-year-old woman with advanced colorectal cancer who was treated with oxaliplatin on a FOLFOX schedule. After 3 cycles of chemotherapy, she started to complain of visual loss, altered color vision and neurological symptoms. Due to the suspicion of ocular and neurological toxicity, antineoplastic treatment was stopped. Her visual field showed a concentric bilateral scotoma and the electrooculogram test revealed severe impairment of the retinal pigment epithelium. Visual acuity, color vision and visual field recovered completely 8 months later, although electrooculogram remained abnormal. Ocular toxicity has been reported as an infrequent adverse event of oxaliplatin. Findings in this case indicate toxicity of this chemotherapeutic agent on the retinal pigment epithelium, which has not been reported before. This damage could be permanent, and it thus differs from previously described oxaliplatin-induced ocular toxicities, which are usually transient and reversible. With increasing use of oxaliplatin as first-line treatment in advanced colorectal cancer, we have to be aware of this possible toxicity.
我们报告了一例52岁晚期结直肠癌女性患者，其接受了FOLFOX方案的奥沙利铂治疗。化疗3个周期后，她开始出现视力下降、色觉改变及神经症状。由于怀疑存在眼部及神经毒性，停止了抗肿瘤治疗。她的视野显示双侧同心性暗点，眼电图检查显示视网膜色素上皮严重受损。8个月后，视力、色觉和视野完全恢复，尽管眼电图仍异常。眼部毒性已被报道为奥沙利铂罕见的不良事件。该病例的发现表明这种化疗药物对视网膜色素上皮有毒性，此前尚未有过相关报道。这种损害可能是永久性的，因此与先前描述的奥沙利铂引起的眼部毒性不同，后者通常是短暂且可逆的。随着奥沙利铂在晚期结直肠癌一线治疗中的使用增加，我们必须意识到这种可能的毒性。
