Abstract：
BACKGROUND: Trastuzumab improved the prognosis of patients with human epidermal growth factor receptor 2 (HER2)+ breast cancer (BC). Here, we present a patient who developed acute vision loss due to optic atrophy in both eyes after trastuzumab.
METHODS: A 60-year-old female patient was diagnosed with locally advanced HER2+ BC in January 2021. After four cycles of neoadjuvant anthracycline-based chemotherapy followed by four cycles of docetaxel, trastuzumab, and pertuzumab combined treatment, the patient underwent a right modified radical mastectomy. Three days after the end of the second cycle of adjuvant trastuzumab, she presented with acute vision loss. The patient\'s visual acuity was 90% in the right eye and 60% in the left eye. The left eye had optic nerve edema and spindle hemorrhages. First, on suspicion of optic neuritis, the patient was given a 1 gram/day pulse steroid for three days. However, optic neuritis was not considered during the follow-up. Metastasis was considered at the exit of the left optic nerve. Trastuzumab was started by making a mutual decision with the patient. Six days after the sixth dose of adjuvant trastuzumab, she presented with almost complete vision loss.
METHODS: The patient was diagnosed with optic neuritis, and a pulse steroid was administered. Trastuzumab was permanently discontinued. However, the patient\'s visual acuity in both eyes remained at 5-10%.
CONCLUSIONS: Vision loss due to optic neuritis is a devastating side effect. Understanding that trastuzumab-induced optic neuritis may develop will help clinicians detect side effects early and manage them more effectively.
METHODS: A 60-year-old female patient was diagnosed with locally advanced HER2+ BC in January 2021. After four cycles of neoadjuvant anthracycline-based chemotherapy followed by four cycles of docetaxel, trastuzumab, and pertuzumab combined treatment, the patient underwent a right modified radical mastectomy. Three days after the end of the second cycle of adjuvant trastuzumab, she presented with acute vision loss. The patient\'s visual acuity was 90% in the right eye and 60% in the left eye. The left eye had optic nerve edema and spindle hemorrhages. First, on suspicion of optic neuritis, the patient was given a 1 gram/day pulse steroid for three days. However, optic neuritis was not considered during the follow-up. Metastasis was considered at the exit of the left optic nerve. Trastuzumab was started by making a mutual decision with the patient. Six days after the sixth dose of adjuvant trastuzumab, she presented with almost complete vision loss.
METHODS: The patient was diagnosed with optic neuritis, and a pulse steroid was administered. Trastuzumab was permanently discontinued. However, the patient\'s visual acuity in both eyes remained at 5-10%.
CONCLUSIONS: Vision loss due to optic neuritis is a devastating side effect. Understanding that trastuzumab-induced optic neuritis may develop will help clinicians detect side effects early and manage them more effectively.
摘要：
背景：曲妥珠单抗可改善人表皮生长因子受体2（HER2）+乳腺癌（BC）患者的预后。这里,我们介绍了1例曲妥珠单抗治疗后,双眼视神经萎缩导致急性视力丧失的患者.
方法：一名60岁女性患者于2021年1月被诊断为局部晚期HER2+BC。经过四个周期的新辅助蒽环类药物化疗，然后进行四个周期的多西他赛，曲妥珠单抗,和帕妥珠单抗联合治疗，患者接受了右改良根治术.第二个周期结束后三天的佐剂曲妥珠单抗，她出现了急性视力丧失。患者的视力在右眼为90%，在左眼为60%。左眼有视神经水肿和梭形出血。首先,怀疑有视神经炎,患者接受1克/天脉冲类固醇治疗,持续3天.然而,随访期间未考虑视神经炎.在左视神经出口处考虑转移。曲妥珠单抗是通过与患者共同决定开始的。第六剂佐剂曲妥珠单抗后六天，她的视力几乎完全丧失。
方法：患者被诊断为视神经炎，并服用了脉冲类固醇。曲妥珠单抗被永久停用。然而,患者的双眼视力保持在5-10%。
结论：视神经炎导致的视力丧失是一种毁灭性的副作用。了解曲妥珠单抗诱导的视神经炎可能发展将有助于临床医生及早发现副作用并更有效地管理它们。
方法：一名60岁女性患者于2021年1月被诊断为局部晚期HER2+BC。经过四个周期的新辅助蒽环类药物化疗，然后进行四个周期的多西他赛，曲妥珠单抗,和帕妥珠单抗联合治疗，患者接受了右改良根治术.第二个周期结束后三天的佐剂曲妥珠单抗，她出现了急性视力丧失。患者的视力在右眼为90%，在左眼为60%。左眼有视神经水肿和梭形出血。首先,怀疑有视神经炎,患者接受1克/天脉冲类固醇治疗,持续3天.然而,随访期间未考虑视神经炎.在左视神经出口处考虑转移。曲妥珠单抗是通过与患者共同决定开始的。第六剂佐剂曲妥珠单抗后六天，她的视力几乎完全丧失。
方法：患者被诊断为视神经炎，并服用了脉冲类固醇。曲妥珠单抗被永久停用。然而,患者的双眼视力保持在5-10%。
结论：视神经炎导致的视力丧失是一种毁灭性的副作用。了解曲妥珠单抗诱导的视神经炎可能发展将有助于临床医生及早发现副作用并更有效地管理它们。
