Hospital Vital Álvarez Buylla, Santuyano, Mieres, Principado de Asturias, España.
Hospital Vital Álvarez Buylla, Santuyano, Mieres, Principado de Asturias, España.
Arch Soc Esp Oftalmol (Engl Ed). 2020 Oct;95(10):485-495. doi: 10.1016/j.oftal.2020.05.030. Epub 2020 Jun 27.
Although taxanes are a frequently used group of chemotherapy agents, they can, rarely, lead to macular oedema. The purpose of this article is to review and communicate, in an integrated way, the data of the cases previously reported in the literature, as well as to present a new case.
Narrative review of reports of cases of macular oedema associated with taxanes, and communication of the clinical case of a 73-year-old woman who, after treatment with paclitaxel for metastatic breast cancer, developed macular oedema that disappeared after discontinuing the drug.
The review included 57 cases with data from 109 eyes collected in 52 articles. The large majority (76.79%) of the cases were women, and the mean age was 58.75 years. The cancer that most frequently motivated the treatment was breast cancer (60.72%), and 92.5% of cases had metastases. The most frequently associated drug was paclitaxel (52.63%). The median time to symptom development was 4.25 months. At the initial examination, 92.86% of the cases had bilateral oedema and the mean visual acuity was 0.4 (decimal scale). The mean macular thickness was 509.63 microns, and 97.83% of the eyes had no or minimal angiographic findings. In 90.57% of the cases, the treatment with taxanes was interrupted, and some other treatment was used in 43.86% of the cases, with the most widely used being acetazolamide. The outcome was favourable, to a greater or lesser extent, in 96.23% of cases.
Despite being a rare entity, macular oedema associated with the use of taxanes is a disorder that every oncologist and ophthalmologist should be aware of, taking into account the good outcome of the condition that usually occurs when treatment is suspended.
尽管紫杉烷类药物是一种常用的化疗药物，但它们很少会导致黄斑水肿。本文旨在综合回顾和交流文献中先前报道的病例数据，并报告一个新病例。
对与紫杉烷类药物相关的黄斑水肿病例报告进行叙述性回顾，并交流一位 73 岁女性的临床病例。该患者在接受紫杉醇治疗转移性乳腺癌后出现黄斑水肿，停药后水肿消失。
共纳入 57 例病例，来自 52 篇文献中的 109 只眼，数据完整。其中，绝大多数（76.79%）为女性，平均年龄为 58.75 岁。最常见的促使治疗的癌症是乳腺癌（60.72%），92.5%的病例有转移。最常相关的药物是紫杉醇（52.63%）。症状出现的中位时间为 4.25 个月。初次检查时，92.86%的病例为双眼水肿，平均视力为 0.4（十进制）。平均黄斑厚度为 509.63 微米，97.83%的眼无或仅有轻微的血管造影发现。紫杉烷类药物治疗中断的病例占 90.57%，43.86%的病例使用了其他治疗方法，最广泛使用的是乙酰唑胺。96.23%的病例结果不同程度地好转。
尽管黄斑水肿与紫杉烷类药物相关是一种罕见的情况，但每一位肿瘤学家和眼科医生都应该了解这种疾病，因为当停止治疗时，这种疾病通常会有较好的结果。
