Prevention of ocular toxicity of carmustine (BCNU) with supraophthalmic intracarotid infusion.
Intracarotid administration of carmustine (BCNU) is an increasingly accepted therapeutic modality for primary brain tumors. Its beneficial effect on prolonging survival, however, is countered by its frequent delayed complication of retinal toxicity and severe visual loss, which reportedly occurs in approximately 70% of the patients. Since this complication probably results from increased flow of the drug into the ophthalmic artery, the authors have attempted to infuse BCNU via a small intracarotid catheter advanced beyond the origin of the ophthalmic artery. In a series of nine patients (average follow-ups, 10.7 months), the authors were successful in treating six patients with exclusively supraophthalmic infusions. None of these patients developed any ocular toxicity. From the remaining three patients, two patients received one infraophthalmic infusion with no retinal toxicity. The third patient, however, who received three infraophthalmic infusions, developed ipsilateral retinopathy. These results suggest that retinopathic complications of intracarotid BCNU can be avoided if the infusion catheter is advanced beyond the origin of the ophthalmic artery.
D000293:Adolescent; D000328:Adult; D002330:Carmustine / Q000008:administration & dosage* / Q000009:adverse effects; D002339:Carotid Arteries; D005123:Eye / Q000187:drug effects*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery; D014786:Vision Disorders / Q000139:chemically induced / Q000517:prevention & control
D002330:Carmustine