Persistent severe visual and electroretinographic abnormalities after intravenous Cisplatin therapy.
A 55-year-old man inadvertently received four times the intended dose of intravenous cisplatin as part of a chemotherapeutic salvage regimen for non-Hodgkin lymphoma. Immediately after treatment, he developed bilateral irreversible visual loss. Visual acuity was 20/300 in OU and visual fields showed central scotomas bilaterally. Although the fundus examination findings were normal, an electroretinogram showed markedly reduced a-wave amplitudes and absent b-waves. At autopsy 8 months later, photoreceptors appeared normal. Splitting of the outer plexiform layer was present, consistent with loss of the ERG b-wave. This is the first reported case of persistent visual loss from intravenous cisplatin toxicity and the first case to describe ocular histopathologic findings.
Katz
Bradley J
BJ
John A Moran Eye Center, University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA. bradley.katz@hsc.utah.edu
Ward
John H
JH
Digre
Kathleen B
KB
Creel
Donnell J
DJ
Mamalis
Nick
N
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects*; D062787:Drug Overdose; D004596:Electroretinography; D017809:Fatal Outcome; D006801:Humans; D007275:Injections, Intravenous; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology / Q000503:physiopathology; D016879:Salvage Therapy / Q000009:adverse effects; D012607:Scotoma / Q000209:etiology; D014786:Vision Disorders / Q000139:chemically induced* / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D014792:Visual Acuity
D000970:Antineoplastic Agents; D002945:Cisplatin