Impaired retinal pigment epithelium in paclitaxel-induced macular edema: A case report.

RATIONALE

Cystoid macular edema (CME) is a rare complication of the paclitaxel. However, the pathophysiology was unknown.

PATIENT CONCERNS

A 60-year-old female presented with bilateral blurred vision due to cystoid macular edema after taking 12-course paclitaxel for her breast cancer. Optical coherence tomography (OCT), fluorescein angiography (FAG), indocyanine green angiography (ICGA), electroretinogram (ERG) and electrooculogram (EOG) were performed.

DIAGNOSES

Paclitaxel-induced macular edema.

INTERVENTIONS

Paclitaxel was discontinued and supportive treatment with pentoxifylline was given.

OUTCOMES

The OCT showed bilateral cystoid macular edema. Impaired filling of choriocapillaries was noted on the ICGA; while EOG revealed decreased Arden ratio. The visual acuity, cystoid macular edema and decreased Arden ratio improved slowly over six months.

LESSONS

Paclitaxel rarely causes cystoid macular edema. The damage of choriocapillaries and retinal pigment epithelium might be the underlying cause. Immediate discontinuation of the drug helps visual recovery.