title: Persistent severe visual and electroretinographic abnormalities after intravenous Cisplatin therapy.
abstract: 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.
authors.affiliation: John A Moran Eye Center, University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA. bradley.katz@hsc.utah.edu
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Katz
authors.forename: John H
authors.initials: JH
authors.lastname: Ward
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Digre
authors.forename: Donnell J
authors.initials: DJ
authors.lastname: Creel
authors.forename: Nick
authors.initials: N
authors.lastname: Mamalis
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin