Abduraman Suher, Maliş Bogdana, Celebi Ali Riza Cenk
Clinical Emergency Eye Hospital, Bucharest, Romania.
Department of Ophthalmology, Acibadem University School of Medicine, Istanbul, Turkey.
GMS Ophthalmol Cases. 2025 Jul 15;15:Doc07. doi: 10.3205/oc000255. eCollection 2025.
Metastatic breast cancer leads to significant challenges in terms of treatment and management, often requiring a multidisciplinary approach due to the potential side effects of chemotherapy and radiotherapy.
We present a case of a metastatic breast cancer patient with central serous chorioretinopathy, recurrent cystoid macular edema, and radiation-induced optic neuropathy that occurred after the treatment with paclitaxel and radiation. A 42-year-old female patient presented to our department with a one-week history of painless, subacute vision loss in her left eye, occurring one year after completing oncological treatment. Her best corrected visual acuity (BCVA) was 20/32 in her left eye, and the optical coherence tomography (OCT) showed central serous chorioretinopathy with spontaneous resolution within 1 month. Seven months later, she presented with a sudden decrease in vision in her right eye; the BCVA was 20/40, the relative afferent pupillary defect was found, and the visual field demonstrated a superior altitudinal defect corresponding to the inferior segmental optic nerve pallor, prompting us to start treatment with prednisolone. Six months later, her vision had fallen to light perception in the right eye and 20/25 in the left eye. The OCT findings were conclusive for cystoid macular edema in her left eye, so we started treatment with aflibercept. Unfortunately, we could not improve the visual outcome in the right eye, which had an amaurotic pupil. Regarding the left eye, the patient experienced recurrent macular edema treated with aflibercept. After several episodes, the patient's BCVA decreased to 20/50 without any improvement.
Herein we stated a young patient with metastatic breast cancer who developed a rare and unusual overlap of side effects: paclitaxel-associated retinopathy and radiation-induced optic neuropathy. We aim to illustrate the challenge of managing advanced breast cancer patients and emphasize the importance of careful monitoring for ocular complications, which can impact the patient's quality of life.
转移性乳腺癌在治疗和管理方面带来了重大挑战，由于化疗和放疗的潜在副作用，通常需要多学科方法。
我们报告一例转移性乳腺癌患者，其在接受紫杉醇和放疗后出现了中心性浆液性脉络膜视网膜病变、复发性黄斑囊样水肿和放射性视神经病变。一名42岁女性患者因左眼无痛性亚急性视力丧失一周前来我院就诊，该症状在完成肿瘤治疗一年后出现。她左眼的最佳矫正视力（BCVA）为20/32，光学相干断层扫描（OCT）显示中心性浆液性脉络膜视网膜病变，1个月内自行消退。七个月后，她右眼视力突然下降；BCVA为20/40，发现相对性传入瞳孔障碍，视野显示与下节段视神经苍白相对应的上半侧视野缺损，促使我们开始使用泼尼松龙治疗。六个月后，她右眼视力降至光感，左眼视力为20/25。OCT结果确诊左眼为黄斑囊样水肿，因此我们开始使用阿柏西普治疗。不幸的是，我们未能改善右眼的视力结果，右眼出现黑蒙性瞳孔。对于左眼，患者出现复发性黄斑水肿，接受阿柏西普治疗。经过几次发作后，患者的BCVA降至20/50，没有任何改善。
在此我们报告了一名患有转移性乳腺癌的年轻患者，其出现了罕见且不寻常的副作用重叠情况：紫杉醇相关性视网膜病变和放射性视神经病变。我们旨在说明管理晚期乳腺癌患者的挑战，并强调仔细监测眼部并发症的重要性，这些并发症可能会影响患者的生活质量。
