Lewis Philippa, Waqar Salman, Yiannakis Dennis, Raman Vasant
Department of Oncology, Derriford Hospital, Plymouth, UK.
Royal Eye Infirmary, Plymouth, UK.
Case Rep Oncol. 2014 Jan 10;7(1):29-32. doi: 10.1159/000357912. eCollection 2014 Jan.
A 48-year-old woman with a positive BRCA1 gene mutation was diagnosed with stage 3b high-grade ovarian endometrioid carcinoma. She was treated with adjuvant carboplatin at a dose of 740 mg (AUC 6) in 3-weekly cycles. Five days after her fifth cycle of carboplatin, she awoke with new-onset blurred vision in her left eye. An ophthalmology review showed left-sided disc oedema with normal optic nerve function tests and 6/24 visual acuity. A CT scan of the head and orbits was performed which showed no evidence of metastasis or raised intracranial pressure. An autoimmune screen was performed which did not reveal any explanation for her visual symptoms. Fundus fluorescein angiography showed bilateral intense late disc leakage with no evidence of vasculitis. Her chemotherapy was stopped in view of a radiological and biochemical remission and her visual symptoms were monitored. She was also started on a tapering dose of prednisolone 40 mg daily. Five months after the initial review, she has developed left optic disc atrophy with 6/18 visual acuity, while the right eye remains asymptomatic. The diagnosis was felt to be that of carboplatin-induced unilateral disc oedema, a very rare side effect of this chemotherapy.
一名48岁的女性，其BRCA1基因突变呈阳性，被诊断为3b期高级别卵巢子宫内膜样癌。她接受了辅助性卡铂治疗，剂量为740毫克（AUC 6），每3周一个疗程。在她第五个卡铂疗程后的第五天，她醒来时左眼出现了新发的视力模糊。眼科检查显示左侧视盘水肿，视神经功能测试正常，视力为6/24。进行了头部和眼眶的CT扫描，未发现转移或颅内压升高的迹象。进行了自身免疫筛查，但未发现任何能解释她视觉症状的原因。眼底荧光血管造影显示双侧视盘晚期强烈渗漏，无血管炎迹象。鉴于影像学和生化指标缓解，她的化疗停止，并对其视觉症状进行监测。她还开始每天服用逐渐减量的泼尼松龙40毫克。在初次检查五个月后，她出现了左侧视盘萎缩，视力为6/18，而右眼仍无症状。诊断为卡铂引起的单侧视盘水肿，这是这种化疗非常罕见的副作用。
