Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports
Abstract Background Cystoid macular edema is a rare, vision-threatening side effect of the taxane family of anticancer agents. There is no established treatment or standard treatment protocol for taxane-related cystoid macular edema. Here, we report two cases of taxane-related cystoid macular edema...
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| Format: | Article |
| Language: | English |
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BMC
2021-07-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-021-02954-8 |
| _version_ | 1818640396326010880 |
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| author | Mitsuru Otsubo Reiko Kinouchi Takayuki Kamiya Akitoshi Yoshida |
| author_facet | Mitsuru Otsubo Reiko Kinouchi Takayuki Kamiya Akitoshi Yoshida |
| author_sort | Mitsuru Otsubo |
| collection | DOAJ |
| description | Abstract Background Cystoid macular edema is a rare, vision-threatening side effect of the taxane family of anticancer agents. There is no established treatment or standard treatment protocol for taxane-related cystoid macular edema. Here, we report two cases of taxane-related cystoid macular edema that were treated with topical dorzolamide. Case presentation In case 1, a 72-year-old Japanese woman with bilateral geographic choroiditis reported for a follow-up visit with a complaint of blurred vision in both eyes for 2 months after starting nanoparticle albumin-bound paclitaxel chemotherapy for multiple metastases of her breast cancer. Her best-corrected visual acuity had dropped from 1.2 to 0.9 in the right eye and from 1.0 to 0.4 in the left eye. Fundus examination showed no newly active geographic choroiditis lesion, but optical coherence tomography exhibited cystoid macular edema. We suspected taxane-related cystoid macular edema and terminated nanoparticle albumin-bound paclitaxel, and started topical dorzolamide treatment. Cystoid macular edema nearly resolved within 6 weeks in the right eye and within 10 weeks in the left eye after starting topical dorzolamide treatment. The resolution of cystoid macular edema without leaving a chorioretinal scar after discontinuation of paclitaxel confirmed our initial diagnosis of taxane-related cystoid macular edema. A few inconspicuous cystoid spaces persisted at the parafovea for a year after dorzolamide treatment ended, but regressed after restarting dorzolamide treatment without any side effects. Best-corrected visual acuity improved to 1.2 in the right eye and 1.0 in the left eye. In case 2, a 70-year-old Japanese man, who received nanoparticle albumin-bound paclitaxel for pancreatic cancer with multiple metastases, developed bilateral cystoid macular edema. Best-corrected visual acuity was 0.3 bilaterally. Cystoid macular edema resolved within 5 weeks after stopping nanoparticle albumin-bound paclitaxel and starting topical dorzolamide treatment confirming the diagnosis of taxane-related cystoid macular edema. Nine weeks later, best-corrected visual acuity improved to 0.8 in the right eye and 1.0 in the left eye. Conclusions Cystoid macular edema in each case resolved within a few months without any side effects using topical dorzolamide and terminating taxane-based chemotherapy. Topical dorzolamide appears to be a safe and effective treatment option for patients with taxane-related cystoid macular edema whose quality of life is threatened by visual disturbances. |
| first_indexed | 2024-12-16T23:10:36Z |
| format | Article |
| id | doaj.art-af49e2c0153c401fb4bf328ba329e1a6 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-16T23:10:36Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-af49e2c0153c401fb4bf328ba329e1a62022-12-21T22:12:26ZengBMCJournal of Medical Case Reports1752-19472021-07-011511610.1186/s13256-021-02954-8Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reportsMitsuru Otsubo0Reiko Kinouchi1Takayuki Kamiya2Akitoshi Yoshida3Department of Ophthalmology, Asahikawa Medical UniversityDepartment of Ophthalmology, Asahikawa Medical UniversityDepartment of Ophthalmology, Asahikawa Medical UniversityDepartment of Ophthalmology, Asahikawa Medical UniversityAbstract Background Cystoid macular edema is a rare, vision-threatening side effect of the taxane family of anticancer agents. There is no established treatment or standard treatment protocol for taxane-related cystoid macular edema. Here, we report two cases of taxane-related cystoid macular edema that were treated with topical dorzolamide. Case presentation In case 1, a 72-year-old Japanese woman with bilateral geographic choroiditis reported for a follow-up visit with a complaint of blurred vision in both eyes for 2 months after starting nanoparticle albumin-bound paclitaxel chemotherapy for multiple metastases of her breast cancer. Her best-corrected visual acuity had dropped from 1.2 to 0.9 in the right eye and from 1.0 to 0.4 in the left eye. Fundus examination showed no newly active geographic choroiditis lesion, but optical coherence tomography exhibited cystoid macular edema. We suspected taxane-related cystoid macular edema and terminated nanoparticle albumin-bound paclitaxel, and started topical dorzolamide treatment. Cystoid macular edema nearly resolved within 6 weeks in the right eye and within 10 weeks in the left eye after starting topical dorzolamide treatment. The resolution of cystoid macular edema without leaving a chorioretinal scar after discontinuation of paclitaxel confirmed our initial diagnosis of taxane-related cystoid macular edema. A few inconspicuous cystoid spaces persisted at the parafovea for a year after dorzolamide treatment ended, but regressed after restarting dorzolamide treatment without any side effects. Best-corrected visual acuity improved to 1.2 in the right eye and 1.0 in the left eye. In case 2, a 70-year-old Japanese man, who received nanoparticle albumin-bound paclitaxel for pancreatic cancer with multiple metastases, developed bilateral cystoid macular edema. Best-corrected visual acuity was 0.3 bilaterally. Cystoid macular edema resolved within 5 weeks after stopping nanoparticle albumin-bound paclitaxel and starting topical dorzolamide treatment confirming the diagnosis of taxane-related cystoid macular edema. Nine weeks later, best-corrected visual acuity improved to 0.8 in the right eye and 1.0 in the left eye. Conclusions Cystoid macular edema in each case resolved within a few months without any side effects using topical dorzolamide and terminating taxane-based chemotherapy. Topical dorzolamide appears to be a safe and effective treatment option for patients with taxane-related cystoid macular edema whose quality of life is threatened by visual disturbances.https://doi.org/10.1186/s13256-021-02954-8DorzolamideNab-paclitaxelCystoid macular edemaOptical coherence tomographyTaxane |
| spellingShingle | Mitsuru Otsubo Reiko Kinouchi Takayuki Kamiya Akitoshi Yoshida Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports Journal of Medical Case Reports Dorzolamide Nab-paclitaxel Cystoid macular edema Optical coherence tomography Taxane |
| title | Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports |
| title_full | Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports |
| title_fullStr | Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports |
| title_full_unstemmed | Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports |
| title_short | Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports |
| title_sort | regression of taxane related cystoid macular edema after topical dorzolamide treatment two case reports |
| topic | Dorzolamide Nab-paclitaxel Cystoid macular edema Optical coherence tomography Taxane |
| url | https://doi.org/10.1186/s13256-021-02954-8 |
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