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Paclitaxel may be a risk factor for retinal phototoxicity

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Title: Paclitaxel may be a risk factor for retinal phototoxicity
Authors: Jonathan Malcolm, Caroline Oi Lune Wong, Jared Ching, Shohista Saidkasimova
Source: American Journal of Ophthalmology Case Reports, Vol 25, Iss , Pp 101292- (2022)
Publisher Information: Elsevier, 2022.
Publication Year: 2022
Collection: LCC:Ophthalmology
Subject Terms: Paclitaxel, Vitrectomy, Phototoxicity, Photosensitizer, Retina, Ophthalmology, RE1-994
More Details: Purpose: To report the first case, to our knowledge, of suspected paclitaxel induced phototoxic maculopathy following vitrectomy surgery. Observations: A 62-year-old phakic female receiving paclitaxel therapy for ovarian carcinoma presented with a best corrected visual acuity (BCVA) of 20/40 OD with an epiretinal membrane (ERM) and lamellar macular hole on spectral domain optical coherence tomography (SD-OCT). The patient underwent an uneventful pars plana vitrectomy with ERM peel using standard illumination and vitrectomy settings. Membrane Blue Dual (DORC, Netherlands) was used to stain the ERM. Two weeks post-operatively, the patient presented with a reduced BCVA of 20/200 in the operated eye. Fluorescein and indocyanine green angiography revealed right sided patchy hypofluorescence and hyperfluorescence secondary to retinal pigment epithelium changes with intact choroidal and retinal vasculature. SD-OCT and fundoscopy showed right sided loss of ellipsoid layer, increased reflectivity within the retinal pigmented epithelium and subretinal fibrosis without cystoid macular edema. Four months post-operatively her vision had stabilized to 20/160; unfortunately, the patient was palliated a month later due to ovarian carcinoma progression. Conclusions: A number of drugs are known to increase photosensitivity to solar and artificial forms of radiation. Paclitaxel use has been widely reported to cause dermatological photosensitivity. We report a case of suspected paclitaxel induced phototoxic maculopathy following endoillumination during vitrectomy surgery.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2451-9936
Relation: http://www.sciencedirect.com/science/article/pii/S245199362200038X; https://doaj.org/toc/2451-9936
DOI: 10.1016/j.ajoc.2022.101292
Access URL: https://doaj.org/article/762f46a15112436bbe84b8e963aa3d4e
Accession Number: edsdoj.762f46a15112436bbe84b8e963aa3d4e
Database: Directory of Open Access Journals
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  Data: Purpose: To report the first case, to our knowledge, of suspected paclitaxel induced phototoxic maculopathy following vitrectomy surgery. Observations: A 62-year-old phakic female receiving paclitaxel therapy for ovarian carcinoma presented with a best corrected visual acuity (BCVA) of 20/40 OD with an epiretinal membrane (ERM) and lamellar macular hole on spectral domain optical coherence tomography (SD-OCT). The patient underwent an uneventful pars plana vitrectomy with ERM peel using standard illumination and vitrectomy settings. Membrane Blue Dual (DORC, Netherlands) was used to stain the ERM. Two weeks post-operatively, the patient presented with a reduced BCVA of 20/200 in the operated eye. Fluorescein and indocyanine green angiography revealed right sided patchy hypofluorescence and hyperfluorescence secondary to retinal pigment epithelium changes with intact choroidal and retinal vasculature. SD-OCT and fundoscopy showed right sided loss of ellipsoid layer, increased reflectivity within the retinal pigmented epithelium and subretinal fibrosis without cystoid macular edema. Four months post-operatively her vision had stabilized to 20/160; unfortunately, the patient was palliated a month later due to ovarian carcinoma progression. Conclusions: A number of drugs are known to increase photosensitivity to solar and artificial forms of radiation. Paclitaxel use has been widely reported to cause dermatological photosensitivity. We report a case of suspected paclitaxel induced phototoxic maculopathy following endoillumination during vitrectomy surgery.
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