Ocular toxicity following high dose chemotherapy and autologous transplant.
A 49-year-old woman received an autologous transplant for breast cancer. Six weeks later she noticed visual disturbance of the left eye which correlated with a visual field abnormality. There was a milder degree of visual disturbance in the right eye. Treatment with high-dose steroids partially stabilized the problem, which was felt to be an ischemic optic neuropathy. She ultimately died of respiratory failure. Pathology of the optic nerves revealed demyelination. Visual disturbances following high-dose chemotherapy are uncommon; the pathology to date has not been elucidated. Steroid therapy may be useful.
Rubin
P
P
Department of Hematology/Oncology, Pathology and Ophthalmology, Duke University Medical Center, Durham, NC 27710, USA.
Hulette
C
C
Khawly
J A
JA
Elkordy
M
M
Hussein
A
A
Vredenburgh
J J
JJ
Jaffe
G J
GJ
Peters
W P
WP
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D001943:Breast Neoplasms / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003711:Demyelinating Diseases / Q000139:chemically induced* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007511:Ischemia / Q000139:chemically induced* / Q000175:diagnosis; D015411:Mastectomy, Modified Radical; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009900:Optic Nerve / Q000098:blood supply*; D010257:Paraneoplastic Syndromes / Q000175:diagnosis; D012131:Respiratory Insufficiency / Q000209:etiology; D012607:Scotoma / Q000139:chemically induced; D019172:Transplantation Conditioning; D014794:Visual Fields
D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D005472:Fluorouracil; D008727:Methotrexate