Purpose: We report the findings in two cases of optic neuropathy presenting as a rare complication induced by cisplatin(CDDP)and carboplatin(CBDCA)in reducing the side effects of CDDP.
Case 1: The patient was a 72-year-old male who visited our hospital complaining of a constricted visual field in both eyes 3 months after treatment with CBDCA and pemetrexed chemotherapy for malignant pleural mesothelioma. His visual acuity was(0.6)OD and(1.0)OS, and papilledema and disc hemorrhage were observed in both eyes. Relative afferent pupillary defect(RAPD)was present in the right eye, and a peripheral visual field defect excluding the central 15° was observed in both eyes. CBDCA-induced optic neuropathy was suspected, but chemotherapy was prioritized and continued from the first visit to 75 days later. His visual acuity was(0.7)OD and(0.9)OS, respectively, and the peripheral visual field defect persisted one year later.
Case 2: The patient was a 70-year-old male who experienced deterioration of vision 4 months after fluorouracil and CDDP chemotherapy for esophageal cancer and visited his doctor, who observed papilledema in both eyes. Visual acuity was(1.0)OD and(0.9)OS. The right eye showed RAPD and supra/nasal visual field defects. CDDP-induced optic neuropathy was suspected, so the chemotherapy was changed. After 137 days, the visual acuity of both eyes improved to(1.2).
Conclusion: Case 2, in which CDDP was changed early, showed good visual prognosis. Although the prognosis of visual function is affected by the timing of discontinuation, the timing of the change should be based on the severity of the primary disease.
View full abstract