Department of Ophthalmology, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
BMC Ophthalmol. 2014 Feb 24;14:18. doi: 10.1186/1471-2415-14-18.
To describe the first reported case of toxic optic neuropathy secondary to docetaxel (Taxotere®) chemotherapy.
A 53-year-old female presented with predominantly unilateral visual loss, but extensive bilateral visual field defects and bilateral optic nerve head swelling 2 weeks after first dose of docetaxel (Taxotere®) and trastuzumab (Herceptin®) chemotherapy for a left sided node-positive, HER2 positive breast cancer. Extensive investigation ruled out other causes of optic neuropathy. She was treated with high dose corticosteroids intravenously for 1 week then a tapering oral dose over 8 weeks. Visual field defects gradually resolved and visual acuity improved. Docetaxel chemotherapy was discontinued but targeted therapy with trastuzumab continued without further complication.
Docetaxel can cause a toxic optic neuropathy possibly due to an ischemic or neurotoxic mechanism at the optic nerve head. With cessation of docetaxel therapy and treatment with systemic corticosteroids, visual recovery can occur without significant residual visual deficit.
描述首例与多西紫杉醇（泰索帝®）化疗相关的中毒性视神经病变。
一名 53 岁女性，因左侧淋巴结阳性、HER2 阳性乳腺癌，接受多西紫杉醇（泰索帝®）和曲妥珠单抗（赫赛汀®）化疗，在首次用药后 2 周出现单侧视力丧失为主，但广泛双侧视野缺损和双侧视神经头肿胀。广泛的检查排除了其他视神经病变的原因。她接受了 1 周的大剂量静脉注射皮质类固醇治疗，然后口服剂量逐渐减少，持续 8 周。视野缺损逐渐恢复，视力有所提高。停用多西紫杉醇化疗，但继续进行曲妥珠单抗靶向治疗，无进一步并发症。
多西紫杉醇可能导致中毒性视神经病变，其机制可能为视神经头部的缺血性或神经毒性。停止多西紫杉醇治疗并进行全身皮质类固醇治疗后，视力恢复良好，无明显残留视力缺陷。
