Bilateral optic disc oedema and associated optic neuropathy in the setting of FOLFOX chemotherapy.
BACKGROUND
To report a case of bilateral optic disc oedema and associated optic neuropathy in the setting of FOLFOX chemotherapy.


METHODS
A case of a 57-year-old male being treated with FOLFOX chemotherapy for stage 3B colorectal cancer, who developed bilateral optic disc oedema and associated left sided optic neuropathy is described. The patient presented following cycles 7, 8 and 9 of chemotherapy with a history of bilateral simultaneous intermittent inferior altitudinal field defects. These episodes progressed to bilateral optic nerve oedema and a subsequent left sided optic neuropathy. The patient's symptoms and oedema regressed with discontinuation of chemotherapy.


CONCLUSIONS
This is the first report suggesting a vasospastic role of 5-fluoruracil in 5-FU associated optic neuropathy. It highlights that 5-FU may have the potential to cause arterial vasospasm outside the cardiac vasculature, resulting in end-organ optic nerve ischaemia.
Royal Brisbane and Women's Hospital, Brisbane, QLD 4006, Australia. lturner22@hotmail.com
Liam D
LD
Turner
John D
JD
Harrison
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy; D005472:Fluorouracil / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000139:chemically induced*; D009944:Organoplatinum Compounds / Q000009:adverse effects; D010211:Papilledema / Q000139:chemically induced*
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil