Severe ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy.
OBJECTIVE
To report severe ocular and orbital toxicity after administration of intracarotid etoposide phosphate and carboplatin.


METHODS
Case report.


RESULTS
A 52-year-old man with glioblastoma multiforme underwent left intracarotid administration of eto poside phosphate and carboplatin inferior to the ophthalmic artery. Within 7 hours, a nonpupillary block angle-closure glaucoma developed secondary to uveal effusion in the ipsilateral eye, which was relieved by cycloplegia. Four days later, severe orbital inflammation resulted in a visual acuity of counting fingers, proptosis, optic neuropathy, and total external ophthalmoplegia in the eye. The patient's condition improved after a lateral cantholysis and administration of high-dose intravenous corticosteroids. Two weeks later, an anterior uveitis occurred in the left eye, which responded to topical corticosteroids. During a 2-month period, the patient recovered to a visual acuity of 20/70, near normal motility, and normal intraocular pressure, and the ocular and orbital inflammation resolved. Preexisting ipsilateral chemotherapy-induced maculopathy became more pronounced.


CONCLUSIONS
Ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy is infrequently reported.
Department of Ophthalmology, Casey Eye Institute, Oregon Health Sciences University, Portland 97201-4197, USA. lauera@ohsu.edu
A K
AK
Lauer
J L
JL
Wobig
W T
WT
Shults
E A
EA
Neuwelt
M W
MW
Wilson
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000188:drug therapy; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects*; D002343:Carotid Artery, Internal; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005128:Eye Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D005909:Glioblastoma / Q000188:drug therapy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D009943:Organophosphorus Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D009943:Organophosphorus Compounds; C061400:etoposide phosphate; D005047:Etoposide; D016190:Carboplatin