title: Assessment of ocular neurotoxicity in patients treated with systemic cancer chemotherapeutics.
abstract: OBJECTIVE
  Cisplatin and Paclitaxel are two chemotherapeutic agents known to produce neurotoxicity when used for cumulative dose regimens. In this study we aim to assess their toxicity in the optic nerve, and to evaluate the retinal nerve fibre layer (RNFL) thickness and visual field changes in lung cancer patients treated with Cisplatin and Paclitaxel.
  
  
  METHODS
  Fifteen patients who were treated intravenously with 75 mg/m(2) cisplatin and 175 mg/m(2) paclitaxel every 3 weeks, up to a maximum of six courses, were enrolled in this prospective clinical trial. All patients underwent complete ophthalmological assessments before their treatments began, as well as three months after the completion of their treatments. The RNFL thickness measurements were performed using optical coherence tomography (OCT). Functional testing included the use of frequency-doubling technology (FDT) perimetry and the Humphrey visual field analyser (HFA). The main outcome measurements included the average RNFL thicknesses and visual field indices (mean deviation [MD] and pattern standard deviation [PSD]).
  
  
  RESULTS
  The median age of the 15 patients (nine male and six female) was 63.49 years old (range: 53-77). The average RNFL thickness measurement during the baseline examination was 103.73 μm (range: 97-111). Three months after the cessation of treatment the RNFL thickness declined to 97.4 μm (range: 91-102). Statistical analysis showed a significant thinning between the two measurements (p = 0.032). The MD and PSD values recorded by the HFA demonstrated no statistically significant changes 3 months after the cessation of treatment (p > 0.207 and p > 0.186, respectively). There were statistically significant decreases in both the MD (0.48 to -1.13 dB) and PSD (2.13 to 0.65 dB) indices measured by the FDT perimetry (p = 0.041 and p = 0.025, respectively).
  
  
  CONCLUSIONS
  In our study, the systemic administration of Cisplatin and Paclitaxel affected the peripapillary RNFL thicknesses and visual field indices as revealed by FDT perimetry. OCT and FDT perimetry may be adjunctive tools for the screening of ocular toxicity in patients treated with these agents.
authors: Department of Ophthalmology and.
authors: Berker
authors: B
authors: Bakbak
authors: Sansal
authors: S
authors: Gedik
authors: Bengu Ekinci
authors: BE
authors: Koktekir
authors: Kamil
authors: K
authors: Yavuzer
authors: Baykal
authors: B
authors: Tulek
authors: Fikret
authors: F
authors: Kanat
authors: Esra
authors: E
authors: Pancar
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000187:drug effects* / Q000473:pathology; D009900:Optic Nerve / Q000187:drug effects* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D014794:Visual Fields / Q000187:drug effects*
chemical_list: D017239:Paclitaxel; D002945:Cisplatin