Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA.
Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA.
Eur J Ophthalmol. 2022 Jan;32(1):602-611. doi: 10.1177/1120672120969045. Epub 2020 Nov 4.
To investigate ophthalmic side effects of taxanes and compare side effect frequency, requirement for cessation of taxane therapy, visual acuity outcome, and concurrent systemic effects between paclitaxel and docetaxel.
Patients taking taxanes at a single center from 1/1/2010 to 2/29/2020 were retrospectively reviewed for clinical characteristics, treatments, and concurrent systemic adverse effects.
Of 1918 patients, 22 (1.1%) experienced an ophthalmic side effect that came to the attention of an eye care provider. Mean age at presentation of the side effect was 62 years (median 66, range 23-82). The most common side effect was meibomian gland dysfunction in 5 (23%) patients, followed by cystoid macular edema in 4 (18%) patients and canalicular obstruction in 4 (18%) patients, followed by diplopia in 2 (9%) patients, and singular cases of lash alopecia, and blepharitis, among others. Lids/lashes as well as nasolacrimal duct adverse effects occurred more frequently with docetaxel therapy than with paclitaxel therapy. Follow-up was available in 10 (45%) patients, with mean duration of 5 months (median 4, range 0-12 months). Of these patients, the ophthalmic side effects were resolved or controlled without discontinuing therapy in 8 (80%) patients. Taxane cessation was required in one patient with docetaxel-related canalicular obstruction and one patient with paclitaxel-related cystoid macular edema.
Ophthalmic taxane-related adverse events are rare with estimated frequency of ophthalmic side effects of about 1%. Nevertheless, it is important that ophthalmologists recognize the range of side effects for optimal management. Most ophthalmic events can be treated with targeted therapy without discontinuation of life-prolonging taxane therapy.
研究紫杉烷类药物的眼部副作用，并比较紫杉醇和多西紫杉醇的副作用频率、停止紫杉烷类药物治疗的需求、视力结果和同时发生的全身影响。
对 2010 年 1 月 1 日至 2020 年 2 月 29 日在一家中心接受紫杉烷治疗的患者进行回顾性分析，以评估其临床特征、治疗方法和同时发生的全身不良反应。
在 1918 例患者中，有 22 例（1.1%）出现了眼部不良反应，需要眼科医生关注。出现不良反应时的平均年龄为 62 岁（中位数 66 岁，范围 23-82 岁）。最常见的眼部不良反应是睑板腺功能障碍（23%的患者），其次是囊样黄斑水肿（18%的患者）和泪道阻塞（18%的患者），随后是复视（9%的患者），以及睫毛脱落、睑缘炎等其他单一病例。与紫杉醇治疗相比，多西紫杉醇治疗时更易发生眼睑/睫毛和鼻泪管不良事件。10 例（45%）患者可获得随访，平均随访时间为 5 个月（中位数 4 个月，范围 0-12 个月）。在这些患者中，8 例（80%）患者的眼部不良反应得到缓解或控制，无需停止治疗。1 例多西紫杉醇相关的泪道阻塞患者和 1 例紫杉醇相关的囊样黄斑水肿患者需要停止使用紫杉烷类药物。
眼部紫杉烷类相关不良反应罕见，眼部不良反应的估计发生率约为 1%。尽管如此，眼科医生识别一系列不良反应对于最佳管理仍然很重要。大多数眼部事件可以通过靶向治疗来治疗，而无需停止延长生命的紫杉烷类药物治疗。
