Abstract:
Various forms of cancer and chemotherapeutics are associated with optic neuropathy. Cisplatin is a platinum analogue chemotherapeutic commonly associated with ocular toxicity among many other serious adverse effects. Carboplatin is a more chemically stable platinum analogue that is generally better tolerated with a comparatively favorable side effect profile. There are very few reports of carboplatin precipitating optic neuropathy. This case report describes a rare occurrence of carboplatin-induced blinding optic neuropathy. We treated a patient receiving carboplatin for neuroendocrine bladder cancer who developed rapidly progressive bilateral optic neuropathy over the course of three days. Upon evaluation at our clinic, his visual acuity had declined to light perception only and 20/60 in his left and right eye, respectively. Carboplatin therapy was immediately held and steroids were initiated. Despite the intervention, the patient\'s visual deficits have not improved at the one-year follow-up. Although the mechanism by which carboplatin causes ocular toxicity remains speculative, arterial ischemia appears to be the likely mechanism given the irreversible nature of visual decline. As demonstrated by our patient\'s course, irreversible vision loss despite high-dose steroid intervention necessitates expeditious recognition and management of this rare adverse effect. .
摘要:
各种形式的癌症和化学疗法与视神经病变有关。顺铂是铂类似物化疗剂,通常与许多其他严重不良反应中的眼部毒性有关。卡铂是化学上更稳定的铂类似物,其通常具有更好的耐受性,具有相对有利的副作用特征。关于卡铂诱发视神经病变的报道很少。此病例报告描述了卡铂引起的致盲性视神经病变的罕见发生。我们对接受卡铂治疗神经内分泌膀胱癌的患者进行了治疗,该患者在三天的时间内发展为快速进行性的双侧视神经病变。在我们的诊所进行评估后,他的视力已经下降到只有光感知和20/60在他的左眼和右眼,分别。立即进行卡铂治疗,并开始使用类固醇。尽管有干预,在一年的随访中,患者的视力缺陷没有改善。尽管卡铂引起眼部毒性的机制仍是推测性的,考虑到视力下降的不可逆性质,动脉缺血似乎是可能的机制。正如我们病人的课程所证明的那样,尽管进行了大剂量类固醇干预,但仍有不可逆的视力丧失需要迅速识别和处理这种罕见的不良反应。。