Paclitaxel- and/or cisplatin-induced ocular neurotoxicity: a case report and literature review

Abstract

Paclitaxel (PTX) and/or cisplatin (CDDP), as important cytotoxic anti-cancer agents, are widely used to treat various solid tumors. Both may cause moderate or severe neurotoxicity, but ocular neurotoxicity is also occasionally reported. A patient diagnosed with nasopharyngeal cancer suffering acute ocular neurotoxicity 10 days after paclitaxel and CDDP administration at the recommended dose is described in the present case report, and PTX- and/or CDDP-induced ocular neurotoxicity are summarized according to previous reports. Possible mechanisms and the potential diagnostic, therapeutic and predictive strategies of PTX- and/or CDDP-induced ocular neurotoxicity are reviewed, to help the oncologist to take the infrequent toxicity of cytotoxic drugs into account and improve patient safety during anti-cancer therapy.

Keywords: CDDP; PTX; chemotherapy; cytotoxic drugs; oncology.

Figure 1

Color wash and dose-volume histogram. Note: The radiation dose distribution at the optic chiasm (red solid line), and the left (green solid line) and right (purple solid line) optic nerves are shown in a color wash (A) and dose-volume histogram (B).

Figure 2

Flash visual-evoked potential and electroretinogram results. Notes: During flash visual-evoked potential (A and B), and electroretinogram (C), there was no waveform observed in the left eye (A and C), but a normal wave was found in the right (B and C). SYSN means the synchronic signal was used during the information acquisition. N75, P100 and N145 are three different waves in pattern visual-evoked potential. Abbreviations: L-frequency, low frequency; H-frequency, high frequency; SYSN, synchronous signal.

Figure 3

Visual field test. Note: Temporal hemianopsia and a nasal peripheral visual field defect were diagnosed during the right eye visual field study. Abbreviations: O/O, 0%; POS, positive; NEG, negative; SITA-fast, Swedish Interactive Threshold Algorithms; RX, correction of refractive errors; DS, Diopter sphere; DC, Diopter cylinder; GHT, Glaucoma Hemifield Test; VFI, visual field index; MD, mean defect; PSD, pattern standard deviation.