Seoul Shinsegae Eye Center, Uijeongbu, Korea.
Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Korean Med Sci. 2018 Feb 12;33(7):e55. doi: 10.3346/jkms.2018.33.e55.
The present study describes our 10-year experience with uveoretinal adverse events that manifest because of chemotherapy.
A retrospective chart review was performed for all patients who presented to the ophthalmologic department while undergoing systemic chemotherapy between July 2005 and June 2015.
A total of 55 patients (mean age, 51.2 years, 38 women [69.1%]) suspected of having uveoretinal disease owing to the use of chemotherapeutic agents alone were enrolled. Breast cancer was the predominant disease (36.4%); noninfectious anterior uveitis (21.8%) was the most common condition. Bilateral involvement was observed in 16 patients (29.1%). Although cisplatin (21.8%) was the most commonly used drug, daunorubicin, cytarabine, tamoxifen, toremifene, and imatinib were also frequently used. The median duration until ophthalmologic diagnosis was 208.5 days (range, 19-5,945 days). The proportion of patients with final visual acuity (VA) < 20/40 Snellen VA (0.5 decimal VA) was 32.7%. However, no relationship was observed between final VA < 20/40 and age, sex, therapeutic agents, and metastasis.
Uveoretinal complications were mostly mild to moderate and exhibited a favorable response to conservative therapy. A considerable number of patients exhibited significant irreversible loss of vision after cessation of the causative chemotherapeutic agent. Ophthalmological monitoring is required during chemotherapy.
本研究描述了我们在过去 10 年中遇到的因化疗引起的葡萄膜视网膜不良事件。
对 2005 年 7 月至 2015 年 6 月期间在眼科部门接受全身化疗的所有患者进行回顾性图表审查。
共纳入 55 例(平均年龄 51.2 岁,38 例女性[69.1%])因使用化疗药物而怀疑患有葡萄膜视网膜疾病的患者。乳腺癌是最常见的疾病(36.4%);最常见的情况是非感染性前葡萄膜炎(21.8%)。16 例患者(29.1%)为双侧受累。虽然顺铂(21.8%)是最常用的药物,但柔红霉素、阿糖胞苷、他莫昔芬、托瑞米芬和伊马替尼也经常使用。眼科诊断的中位时间为 208.5 天(范围为 19-5945 天)。最终视力(VA)<20/40 Snellen VA(0.5 十进制 VA)的患者比例为 32.7%。然而,最终 VA<20/40 与年龄、性别、治疗药物和转移之间无相关性。
葡萄膜视网膜并发症多为轻至中度,对保守治疗反应良好。相当多的患者在停止致病化疗药物后出现明显的不可逆转的视力丧失。化疗期间需要进行眼科监测。