Cone damage in patients receiving high-dose irofulven treatment.
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.
Lee
Michael S
MS
Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44124, USA. leem4@ccf.org
Gupta
Nisha
N
Penson
Richard T
RT
Loewenstein
John
J
Wepner
Meredith S
MS
Seiden
Michael V
MV
Milam
Ann H
AH
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
D018906:Antineoplastic Agents, Alkylating; D005904:Glial Fibrillary Acidic Protein; D012717:Sesquiterpenes; C102714:irofulven; D012243:Rhodopsin