Paclitaxel
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Paclitaxel Cystic maculopathy: case report A 62-year-old woman developed cystic maculopathy during treatment with paclitaxel for liver metastases. In August 2007, the woman had started chemotherapy with IV paclitaxel [Taxol] 90–125 mg, administered once weekly for 3 weeks followed by 1 week of rest, and bevacizumab 435 mg, administered once every 2 weeks. In February 2008, she presented with poor vision in both eyes. Visual acuity was 0.5 in the right eye and 0.2 in the left. Ocular pressure was 12mm Hg in both eyes, and there was a slight nuclear cataract in the ocular media of both eyes. The woman’s vision did not improve or deteriorate, but ocular fundus examination in June demonstrated maculopathy with clear cystoid findings in both eyes. The optic papilla in the right eye appeared slightly hyperfluorescent on fluorescein angiography. Optical coherence tomography was performed, exposing substantial oedema of the outer plexiform layer, with retinal thickness of approximately 600 µm near the centre of the socket in both eyes. A diagnosis of paclitaxel-induced maculopathy was made. Treatment with paclitaxel and bevacizumab was withdrawn. After approximately 1 month, no improvement was seen in maculopathy or visual acuity, leading to the initiation of acetazolamide. Cystic maculopathy improved, and the woman’s visual acuity recovered to 0.5 in both eyes over a 6-month period. Acetazolamide was gradually discontinued, with no recurrence of cystic maculopathy. Author comment: We consider cystic maculopathy is a possible side-effect of paclitaxel, and where patients undergoing paclitaxel treatment come into hospital with visual disturbance, tests must be performed with that possibility in mind. Ito S, et al. A case of cystic maculopathy during paclitaxel therapy. Nippon Ganka Gakkai Zasshi 114: 23-7, No. 1, 2010 [Japanese; summarised from a translation] 803015143 Japan
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Reactions 29 May 2010 No. 1303
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