Summary: | Background
Carboplatin and paclitaxel are two standard chemotherapeutic agents known to cause
neurotoxicity. In this study we aim to evaluate the toxicity by measuring the peripapillary
retinal nerve fibre layer (RNFL) and macular thickness in patients with endometrial and
ovarian cancers receiving them.
Methods
A one-year prospective cohort study involving 28 patients who were treated intravenously
with carboplatin (200-400mg/m2) and paclitaxel (175mg/m2) three-weekly for 6 cycles
was conducted. RNFL and macula thickness were measured using optical coherence
tomography (OCT) before commencement of chemotherapy, after the third cycle, and
one month after the sixth cycle. The main outcome measurements were the average RNFL
thickness and central subfield thickness of macula.
Results
The mean age of the 28 participants was 54.68 years old (SD=9.03). Eleven had
endometrial cancer while 17 had ovarian cancer. The mean of the average RNFL
thickness during baseline pre-chemotherapy was 96.43μm (SD 11.39). One month after
cessation of treatment the mean RNFL thickness increased to 101.57μm (SD 13.54).
Statistical analysis showed a significant increment in the mean RNFL thickness
(p=<0.001), from baseline to after three cycles, and baseline to one-month post six cycles of chemotherapy, except nasal quadrant. The increment in all the macular quadrants was
statistically significant (p < 0.05) except central subfield thickness.
Conclusion
Systemic administration of carboplatin and paclitaxel affected both the peripapillary
RNFL and macula thickness. This represents early evidence of subacute subclinical
retinal toxicity. OCT can be used as a screening tool to assess peri-chemotherapeutic
retinal alterations.
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