Toxic optic neuropathy in the setting of docetaxel chemotherapy: a case report

Abstract

BackgroundTo describe the first reported case of toxic optic neuropathy secondary to docetaxel (Taxotere®) chemotherapy.Case presentationA 53-year-old female presented with predominantly unilateral visual loss, but extensive bilateral visual field defects and bilateral optic nerve head swelling 2 weeks after first dose of docetaxel (Taxotere®) and trastuzumab (Herceptin®) chemotherapy for a left sided node-positive, HER2 positive breast cancer. Extensive investigation ruled out other causes of optic neuropathy. She was treated with high dose corticosteroids intravenously for 1 week then a tapering oral dose over 8 weeks. Visual field defects gradually resolved and visual acuity improved. Docetaxel chemotherapy was discontinued but targeted therapy with trastuzumab continued without further complication.ConclusionDocetaxel can cause a toxic optic neuropathy possibly due to an ischemic or neurotoxic mechanism at the optic nerve head. With cessation of docetaxel therapy and treatment with systemic corticosteroids, visual recovery can occur without significant residual visual deficit.

Current status of eye disorders caused by docetaxel administration every 3 weeks: A case-control study in Japanese patients

“…33 Optic neuropathy has also been associated with DTX and PTX. 24,25,[49][50][51][52] Scaioli et al 52 reported that the most likely mechanism of the visual symptoms and electrophysiological changes caused by PTX use was vascular dysregulation in the retina or ischemia involving the optic nerve.…”

“…Eye disorders, such as watering eyes (epiphora), lacrimal duct obstruction, and cystoid macular edema, have also been reported. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Watering eyes and lacrimal duct obstruction have been frequently reported. [10][11][12][13][14][15][16][17][18][19][20] Intravenously administered DTX is distributed to the tear fluid from the plasma.…”

Optic atrophy after cabazitaxel treatment in a patient with castration-resistant prostate cancer: a case report

“…10 Toxic ON related to docataxel has been previously reported. 11,12 In those cases, symptoms related to ON, such as constriction of visual fields, loss of visual acuity and loss of colour vision started within the first few cycles, gradually worsening over weeks in a subacute fashion. Detailed evaluations including brain and orbital MRIs excluded other aetiologies.…”

Neurofeedback for Chemotherapy Induced Neuropathic Symptoms: A Case Study

“…One case report linked a patient's loss of vision to optic nerve damage during infusion of the taxane drug, docetaxel. This damage was reversed with high-dose steroid therapy (Moloney et al, 2014); however, not all visual changes after chemotherapy are reversible. Another study reported optic neuropathy and retinopathy in 5 patients with permanent visual damage (Khawly et al, 1996).…”