Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, University of Rome Sapienza, St. Andrea Hospital, Rome, Italy.
Pharmacy Unit, INMI Lazzaro Spallanzani, Rome Italy.
Clin Ter. 2022 Jul-Aug;173(4):377-383. doi: 10.7417/CT.2022.2449.
Nab-paclitaxel is a chemotherapeutic drug used to treat various solid malignant tumors. It was conceived with a solvent free formulation to overcome toxicity events and hypersensitivity reactions associated with paclitaxel. However, it still carries ocular adverse effects. The present review examines nab-paclitaxel related cystoid macular edema (CME) and the available therapeutic options.
The literature was reviewed on nab-paclitaxel related CME on published articles through January 2021 using the keywords "nab-paclitaxel "and "cystoid macular edema".
Bilateral CME is found in patients in treatment with nab-paclitaxel and causes considerable visual acuity decline. In ophthalmology multimodal imaging has an integral role in the diagnostic work up of patients and shows characteristic findings in nab-paclitaxel related CME. The case of a patient with treatment for bilateral CME is presented and analyzed.
The preferred management strategy for nab-paclitaxel-related CME is drug cessation that leads to complete resolution of edema. When discontinuation of treatment is not possible due to the systemic conditions of patients, effective alternative therapeutic modalities are topical dorzolamide or steroidal treatment. Given the higher complication hazards of intravitreal therapy topical treatment should be preferred owing to comparable efficacy.
奈达铂是一种用于治疗各种实体恶性肿瘤的化疗药物。它采用无溶剂配方，以克服与紫杉醇相关的毒性事件和过敏反应。然而，它仍然有眼部不良反应。本综述检查了奈达铂相关的囊样黄斑水肿（CME）和可用的治疗选择。
通过使用关键词“nab-paclitaxel”和“cystoid macular edema”，对截至 2021 年 1 月发表的关于奈达铂相关 CME 的文献进行了综述。
接受奈达铂治疗的患者出现双侧 CME，导致视力明显下降。眼科多模态成像在患者的诊断工作中具有重要作用，并显示出奈达铂相关 CME 的特征性发现。介绍并分析了一位双侧 CME 治疗患者的病例。
奈达铂相关 CME 的首选治疗策略是停药，这会导致水肿完全消退。当由于患者的全身状况而不能停止治疗时，有效的替代治疗方法是局部多佐胺或皮质类固醇治疗。由于眼内治疗的并发症风险较高，由于疗效相当，应优先选择局部治疗。
