Mathew David J, Arthur Anupriya, John Sheeja Susan
Department of Ophthalmology, Christian Medical College, Vellore 632001, Tamil Nadu, South India.
Open Ophthalmol J. 2017 Sep 30;11:298-304. doi: 10.2174/1874364101711010298. eCollection 2017.
With the advent of more aggressive cytotoxic chemotherapy regimens, the incidence of ocular toxicity due to these drugs is also on the rise. We report a case of Presumed Chemotherapy-Induced optic neuropathy and maculopathy secondary to treatment with cytarabine and daunorubicin for Acute Myeloid Leukaemia (AML).
A 50-year-old man with AML developed sudden decrease in vision in his left eye after three cycles of chemotherapy with cytarabine and daunorubicin. He presented to us six weeks later with bilateral optic atrophy and foveal atrophic changes with early bull's eye maculopathy. A diagnosis of presumed chemotherapy-induced optic neuropathy with maculopathy was made, and the patient was put on an alternative chemotherapeutic regimen. There was no further decrease in vision on follow up.
To the best of our knowledge, this is the first report of clinically demonstrable macular toxicity in the form of macular atrophic changes and bull's eye maculopathy associated with the use of cytarabine and daunorubicin. Early diagnosis and appropriate management of such cases is imperative to prevent further visual deterioration.
随着更积极的细胞毒性化疗方案的出现,这些药物所致眼部毒性的发生率也在上升。我们报告一例因急性髓系白血病(AML)接受阿糖胞苷和柔红霉素治疗继发的疑似化疗诱导的视神经病变和黄斑病变。
一名50岁AML男性患者在接受三个周期阿糖胞苷和柔红霉素化疗后左眼视力突然下降。六周后他前来就诊,检查发现双侧视神经萎缩、黄斑中心凹萎缩性改变及早期靶心样黄斑病变。诊断为疑似化疗诱导的视神经病变伴黄斑病变,患者改用另一种化疗方案。随访期间视力未进一步下降。
据我们所知,这是首例以黄斑萎缩性改变和靶心样黄斑病变形式出现的与使用阿糖胞苷和柔红霉素相关的临床可证实的黄斑毒性报告。对此类病例进行早期诊断和适当处理对于防止视力进一步恶化至关重要。