Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Department of Medical Oncology, Izmir Katip Celebi University, Izmir, Turkey.
Cutan Ocul Toxicol. 2020 Sep;39(3):287-293. doi: 10.1080/15569527.2020.1790592. Epub 2020 Jul 9.
To evaluate the characteristics of macular retinal and subfoveal choroidal changes in patients already on taxane-based therapy by the help of spectral domain optical coherence tomograpy (SD-OCT) and determine the incidence of taxane- related cystoid macular edema (CME).
In this cross-sectional case-control study, 202 patients who received taxane-based therapy due to treatment of various cancer and age and sex-matched 200 healthy control subjects were examined. Only patients who received at least 4 cycles of taxane-based therapy were taken into consideration for the taxane group. Taxane-based therapy was further divided into two subgroups; paclitaxel group (149 patients) and docetaxel group (53 patients). Central macular thickness (CMT) and central subfoveal choroidal thickness (CCT) were measured just once during their ongoing chemotherapy using SD-OCT and enhanced-depth imaging (EDI) OCT by Heidelberg OCT by a single examiner.
Patients received a median of 7 cycles (range, 4-26) of paclitaxel or docetaxel and received a total cumulative dose of 852.81 ± 368.82 mg/m (range, 300-2310 mg/m). Though the mean CMT was significantly thicker in the taxane group (224.9 ± 28.4 µm) than the healthy control group (215.9 ± 19.7 µm), there was no statistically significant difference between the paclitaxel (225.3 ± 28.2 µm) and docetaxel (224.2 ± 20.1 µm) groups. On the other hand, the CCT was not statistically significant different between the taxane versus control eyes and paclitaxel versus docetaxel patients. Taxane-related CME was detected only in one patient on paclitaxel. Overall, incidence of taxane-related maculopathy was 0.5% (1/202) of all patients in the taxane group.
In our group of taxane receiving patients, incidence of taxane-related CME was 0.5%. In light of our study, we believe that clinicians should be alert on the occurence of taxane-related CME and carefully scrutinize the patients whenever any suspicion is arisen.
利用谱域光相干断层扫描（SD-OCT）评估已接受紫杉烷类药物治疗的患者的黄斑视网膜和中心凹下脉络膜变化特征，并确定紫杉烷类相关囊样黄斑水肿（CME）的发生率。
在这项病例对照的横断面研究中，对 202 名因各种癌症治疗而接受紫杉烷类药物治疗的患者和 200 名年龄和性别匹配的健康对照组进行了检查。仅将接受至少 4 个周期紫杉烷类药物治疗的患者纳入紫杉烷类药物组。紫杉烷类药物治疗进一步分为紫杉醇组（149 例）和多西他赛组（53 例）。通过海德堡 OCT 上的单眼检查，在患者正在进行的化疗期间，仅使用 SD-OCT 和增强深度成像（EDI）OCT 单次测量中央黄斑厚度（CMT）和中心凹下脉络膜厚度（CCT）。
患者接受了中位数为 7 个周期（范围，4-26）的紫杉醇或多西他赛治疗，并接受了 852.81±368.82mg/m2（范围，300-2310mg/m2）的总累积剂量。紫杉烷类药物组的平均 CMT（224.9±28.4μm）明显高于健康对照组（215.9±19.7μm），但紫杉醇组（225.3±28.2μm）和多西他赛组（224.2±20.1μm）之间无统计学差异。另一方面，紫杉烷类药物治疗组与对照组、紫杉醇组与多西他赛组之间的 CCT 无统计学差异。仅在 1 名接受紫杉醇治疗的患者中发现了与紫杉烷类药物相关的 CME。总的来说，在接受紫杉烷类药物治疗的 202 名患者中，有 0.5%（1/202）的患者发生了与紫杉烷类药物相关的黄斑病变。
在我们的紫杉烷类药物治疗组中，与紫杉烷类药物相关的 CME 发生率为 0.5%。根据我们的研究，我们认为临床医生应该警惕与紫杉烷类药物相关的 CME 的发生，并在出现任何怀疑时仔细检查患者。
