title: Central Macular Thickness Monitoring after a Taxane-Based Therapy in Visually Asymptomatic Patients.
abstract: BACKGROUND
  Taxanes are drugs used in various chemotherapeutical protocols to treat solid tumors. They have multiple systemic adverse effects, such as bone marrow suppression, alopecia, nausea, and vomiting, and may rarely cause ocular symptoms. In the past decade, a few reported cases have shown the occurrence of a cystoid macular edema with significant visual loss after the use of a taxane-based chemotherapy. The aim of this study was to compare the central macular thickness (CMT) before and after the initiation of a taxane-based therapy in visually asymptomatic patients and to elucidate the possible impact of these drugs on the vision of cancer patients.
  
  
  METHODS
  Patients with a confirmed diagnosis of a solid tumor were screened for any ophthalmic disease before inclusion and had a baseline macular spectral domain optical coherence tomography (OCT; RTVue-100; Optovue Inc., Fremont, CA, USA) before the initiation of a taxane-based chemotherapy according to different protocols, such as 4EC-4T, 3FEC/3T, or 4TC. OCT was repeated after 4 cycles (or 3 months) of treatment, and CMT was compared to baseline. Patients presenting diabetic retinopathy, age-related macular degeneration or any condition that causes macular edema confirmed by ophthalmic examination were excluded.
  
  
  RESULTS
  Fifty eyes of 25 patients were included; 92% of the subjects were female with a mean age of 48.52 years, 88% were diagnosed with breast cancer, 8% with esophageal cancer, and 4% with ovarian cancer. Docetaxel was the taxane administered to 92% of the patients. The received dose of docetaxel ranged between 110 and 160 mg. The other patients had paclitaxel in their protocols. No significant macular edema or drop in visual acuity were noted in any patient. Nevertheless, the mean CMT was found to be increased, particularly in the parafoveal and perifoveal areas (mean difference of +2.22 μm; p = 0.001).
  
  
  CONCLUSIONS
  Taxane-based chemotherapy regimens seem to increase macular thickness, with a relative sparing of the fovea, in patients without significant macular edema. Further research is required to better explain the pathophysiology and possible impact of this phenomenon.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
authors.forename: Elias
authors.initials: E
authors.lastname: Chelala
authors.forename: Nicolas
authors.initials: N
authors.lastname: Arej
authors.forename: Joelle
authors.initials: J
authors.lastname: Antoun
authors.forename: Hampig Raphael
authors.initials: HR
authors.lastname: Kourie
authors.forename: Karen
authors.initials: K
authors.lastname: Zaarour
authors.forename: Fady Ghassan
authors.initials: FG
authors.lastname: Haddad
authors.forename: Fadi
authors.initials: F
authors.lastname: Farhat
authors.forename: Fadi
authors.initials: F
authors.lastname: El Karak
authors.forename: Joseph
authors.initials: J
authors.lastname: Kattan
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000000981:diagnostic imaging / Q000502:physiology / Q000503:physiopathology*; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D043823:Taxoids / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel