title: Cone damage in patients receiving high-dose irofulven treatment.
abstract: OBJECTIVE
  To describe the clinical, perimetric, and electroretinographic (ERG) results of 4 patients with cone dysfunction following irofulven treatment including the histopathologic and immunocytochemical features of one patient's retinas.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  The patients were examined clinically, including perimetric and ERG evaluations. Eyes from patient 1 and healthy postmortem eyes were processed for histopathologic and immunocytochemistry studies with antibodies specific for cones, rods, and reactive Müller cells.
  
  
  METHODS
  Clinical signs and symptoms, perimetry, ERG, retinal histopathologic and immunocytochemistry study results.
  
  
  RESULTS
  All 4 patients had ERG changes consistent with abnormal cone responses and relatively normal rod responses. Compared with control eyes, the retina of patient 1 had approximately half the normal numbers of macular cones and fewer peripheral cones. The number of rods were normal but all rod and cone outer segments were shortened.
  
  
  CONCLUSIONS
  High-dose irofulven treatment causes cone-specific damage with relative sparing of rods.
authors.affiliation: Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44124, USA. leem4@ccf.org
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.forename: Nisha
authors.initials: N
authors.lastname: Gupta
authors.forename: Richard T
authors.initials: RT
authors.lastname: Penson
authors.forename: John
authors.initials: J
authors.lastname: Loewenstein
authors.forename: Meredith S
authors.initials: MS
authors.lastname: Wepner
authors.forename: Michael V
authors.initials: MV
authors.lastname: Seiden
authors.forename: Ann H
authors.initials: AH
authors.lastname: Milam
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D004596:Electroretinography / Q000187:drug effects; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D017949:Retinal Cone Photoreceptor Cells / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D012243:Rhodopsin / Q000378:metabolism; D012717:Sesquiterpenes / Q000008:administration & dosage / Q000009:adverse effects*; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects
chemical_list: D018906:Antineoplastic Agents, Alkylating; D005904:Glial Fibrillary Acidic Protein; D012717:Sesquiterpenes; C102714:irofulven; D012243:Rhodopsin