Gemcitabine-Induced Retinopathy

Jhaj, Gurdeep; Jhaj, Ruby; Shrier, Eric M.

doi:10.1097/iae.0000000000001857

Cited by 9 publications

(3 citation statements)

References 3 publications

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“…Some studies have reported retinopathy associated with the use of this chemotherapeutic agent. One study demonstrated that one patient had several issues related to use of gemcitabine, such as a decrease in vision with appearance of cotton wool spots and intraretinal hemorrhages [ 133 ]. Another case report described that one patient had macular infarction after chemotherapy with gemcitabine and carboplatin [ 134 ].…”

Section: Drugs and Medicinementioning

confidence: 99%

Retinal Toxicity Induced by Chemical Agents

Araújo

Brito

Pereira-Figueiredo

et al. 2022

IJMS

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Vision is an important sense for humans, and visual impairment/blindness has a huge impact in daily life. The retina is a nervous tissue that is essential for visual processing since it possesses light sensors (photoreceptors) and performs a pre-processing of visual information. Thus, retinal cell dysfunction or degeneration affects visual ability and several general aspects of the day-to-day of a person’s lives. The retina has a blood–retinal barrier, which protects the tissue from a wide range of molecules or microorganisms. However, several agents, coming from systemic pathways, reach the retina and influence its function and survival. Pesticides are still used worldwide for agriculture, contaminating food with substances that could reach the retina. Natural products have also been used for therapeutic purposes and are another group of substances that can get to the retina. Finally, a wide number of medicines administered for different diseases can also affect the retina. The present review aimed to gather recent information about the hazard of these products to the retina, which could be used to encourage the search for more healthy, suitable, or less risky agents.

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Section: Drugs and Medicinementioning

confidence: 99%

Retinal Toxicity Induced by Chemical Agents

Araújo

Brito

Pereira-Figueiredo

et al. 2022

IJMS

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“…It usually causes retinopathy characterized by cottonwool spots and intraretinal hemorrhages with or without subretinal fluid. [269][270][271][272][273] Its appearance has been described as Purtscher-like by some and simply as ischemic vasculopathy by others. Disruption of the outer retina and uveal effusion was reported in 1 case.…”

Section: Diagnostic Testingmentioning

confidence: 99%

The Impact of Systemic Medications on Retinal Function

Somisetty

Santina

Sarraf

et al. 2023

Asia-Pacific Journal of Ophthalmology

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This study will provide a thorough review of systemic (and select intravitreal) medications, along with illicit drugs that are capable of causing various patterns of retinal toxicity. The diagnosis is established by taking a thorough medication and drug history, and then by pattern recognition of the clinical retinal changes and multimodal imaging features. Examples of all of these types of toxicity will be thoroughly reviewed, including agents that cause retinal pigment epithelial disruption (hydroxychloroquine, thioridazine, pentosan polysulfate sodium, dideoxyinosine), retinal vascular occlusion (quinine, oral contraceptives), cystoid macular edema/retinal edema (nicotinic acid, sulfa-containing medications, taxels, glitazones), crystalline deposition (tamoxifen, canthaxanthin, methoxyflurane), uveitis, miscellaneous, and subjective visual symptoms (digoxin, sildenafil). The impact of newer chemotherapeutics and immunotherapeutics (tyrosine kinase inhibitor, mitogen-activated protein kinase kinase, checkpoint, anaplastic lymphoma kinase, extracellular signal-regulated kinase inhibitors, and others), will also be thoroughly reviewed. The mechanism of action will be explored in detail when known. When applicable, preventive measures will be discussed, and treatment will be reviewed. Illicit drugs (cannabinoids, cocaine, heroin, methamphetamine, alkyl nitrite), will also be reviewed in terms of the potential impact on retinal function.

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“…53 yaşında duktal karsinomu tanısı olan olguda çok sayıda cotton-wool spotları, intraretinal hemorajiler ve maküler eksudasyon olduğunu göstermişler, gemsitabin tedavisinin kesilmesinin ardından ek olarak bevacizumab uygulaması ile görme keskinliğinde artış olduğunu ve retinal lezyonların gerilediğini bildirmişlerdir. [9] Tüm bildirilen olgular göz önünde bulundurulduğunda gemsitabin terapisi başlanan olguların özellikle de beraberinde diyabet ve karotis arter hastalığı gibi ek sistemik risk faktörleri de varsa retinal vasküler değişiklikler açısında dikkatle incelenmesi ve takip edilmesi gerekmektedir. Tespit edilmiş retinal toksisite sonrası hastayı takip eden onkolog ile konsültasyon ve ilacın zamanında sonlandırılması retinal patolojilerde gerileme sağlamaktadır.…”

Section: Gemsitabinunclassified

Medications Damaging Vascular Bed or Causing Microvasculopathy / Occlusion-2: Pathogenesis, Diagnosis, and Treatment (Gemcitabine, Fludarabine, Oral contraceptives, Heparin, Cocaine)

2023

Güncel Retina (Current Retina)

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Retinal toxicity can be observed during treatment with many systemic drugs and addictive substances used today. The drugs show their effects on the retina by different mechanisms such as direct toxicity to the retina and retina pigment epithelium, crystalline retinopathy, photoreceptor dysfunction, cystoid macular edema, central serous chorioretinopathy, uveitic effects, and vascular dysfunction. Vascular dysfunction, which is an important subgroup, occurs due to the direct effect of drugs on endothelium, increase in prothrombotic factors, and formation of immunocomplex and vasoconstrictive effects. The primary step in the treatment is to cease the causative agent and replace it with an alternative. In addition, medical or intravitreal injection treatments should be applied according to the retinal vascular pathology.

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Gemcitabine-Induced Retinopathy

Cited by 9 publications

References 3 publications

Retinal Toxicity Induced by Chemical Agents

Retinal Toxicity Induced by Chemical Agents

The Impact of Systemic Medications on Retinal Function

Medications Damaging Vascular Bed or Causing Microvasculopathy / Occlusion-2: Pathogenesis, Diagnosis, and Treatment (Gemcitabine, Fludarabine, Oral contraceptives, Heparin, Cocaine)

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