Retinal toxicity after high-dose cisplatin therapy.

1985 ◽  
Vol 3 (12) ◽  
pp. 1683-1689 ◽  
Author(s):  
G Wilding ◽  
R Caruso ◽  
T S Lawrence ◽  
Y Ostchega ◽  
E J Ballintine ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ovarian Carcinoma ◽  
Causal Relationship ◽  
Color Vision ◽  
Retinal Toxicity ◽  
High Dose ◽  
Visual Dysfunction ◽  
Blurred Vision ◽  
Cone Dysfunction ◽  
Cisplatin Therapy

Because of increasing complaints of visual dysfunction, 13 patients with refractory or recently diagnosed ovarian carcinoma were evaluated for possible cisplatin-induced ophthalmologic toxicity. All patients had received high-dose cisplatin (200 mg/m2 in five divided daily doses) over two to four cycles. Eight patients (62%) developed symptoms of blurred vision and three (23%) also developed altered color perception. Retinal toxicity in the form of cone dysfunction was documented by electroretinography and color vision testing in 11 patients. Three patients were studied prospectively. Two patients who developed cone dysfunction had normal ophthalmologic exams before the initiation of chemotherapy or after one cycle of cisplatin, suggesting a causal relationship between cisplatin therapy and subsequent retinal abnormalities. Though visual acuity improved off therapy, color vision abnormalities persisted as long as 16 months beyond therapy.

A prospective randomized trial comparing high-dose cisplatin with low-dose cisplatin and chlorambucil in advanced ovarian carcinoma.

1986 ◽  
Vol 4 (5) ◽  
pp. 722-729 ◽  
Author(s):  
E Wiltshaw ◽  
B Evans ◽  
G Rustin ◽  
E Gilbey ◽  
J Baker ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Low Dose ◽  
Stage Iv ◽  
Figo Stage ◽  
Stage Iii ◽  
High Dose ◽  
Strong Trend ◽  
To Receive ◽  
Cisplatin Therapy ◽  
Unacceptable Toxicity

Sixty-one patients with FIGO stage III ovarian carcinoma and 30 patients with stage IV ovarian carcinoma were randomized to receive either high-dose cisplatin (100 mg/m2) or low-dose cisplatin (20 mg/m2) and chlorambucil. Overall response rates were similar in both arms, with 68% and 49% of stage III patients and 61% and 72% of stage IV patients responding to high-dose cisplatin and the combination, respectively. There was a strong trend for better survival in stage III (P less than .05) but not in stage IV patients treated with cisplatin alone. The toxicity suffered by patients treated with high-dose cisplatin was severe, and in 15 patients cisplatin therapy was stopped because of unacceptable toxicity.

Bilateral simultaneous orbital decompression for Graves' orbitopathy with a combined endoscopic and Caldwell-Luc approach

2000 ◽  
Vol 122 (2) ◽  
pp. 216-221 ◽  
Author(s):  
Samieh S. Rizk ◽  
Ariadna Papageorge ◽  
Lisa A. Liberatore ◽  
Evan H. Sacks
Keyword(s):  
Visual Acuity ◽  
Color Vision ◽  
High Dose ◽  
Increased Risk ◽  
Orbital Pain ◽  
Testing And Measurement ◽  
Graves Orbitopathy ◽  
Previously Treated ◽  
Vision Deficits ◽  
Visual Disturbances

Graves' orbitopathy can lead to cosmetic deformity, orbital pain, and visual impairment. Surgical intervention can improve proptosis, cosmetic appearance of the eyelids, vision, and orbital pain with minimal morbidity. Ten patients with dysthyroid orbito-pathy underwent concurrent bilateral orbital decompressions. Of these, 9 underwent simultaneous bilateral endoscopic and transantral decompressions, and 1 had only bilateral endoscopic decompressions. Medical management of keratopathy was attempted before surgery. All patients were previously treated with radioiodine and high-dose corticosteroids, and 2 patients had prior low-dose orbital irradiation. Preoperative and postoperative visual acuity, color vision testing, and measurement of proptosis were recorded for all patients. In addition, photographs and CT scans of the orbit and sinuses were done. After surgery, visual acuity improved in 8 patients and remained unchanged in 2 patients. Diplopia in the primary and downward gaze improved in 1 patient and remained unchanged in the 3 others who had it before surgery. Color vision deficits in the blue/yellow range were present in 8 patients before surgery and all reversed within 2 weeks after surgery. Proptosis decreased by an average of 4.83 mm (range 4–7 mm) in patients undergoing the combined decompression and decreased by 4 mm in the 1 patient who had the endoscopic decompression only. Ethmoid sinusitis developed in 1 patient but resolved with oral antibiotics, and another patient had an asymmetric result requiring additional unilateral surgery, which corrected the asymmetry. Overall, this approach avoids external incisions and allows excellent visualization in the regions of the orbital apex and ethmoid roof, facilitating maximal decompression without the increased risk of bleeding or visual disturbances.

scholarly journals Infliximab-related Optic Neuritis in a Patient with Crohn's Disease: a Case Report and Literature Review

2021 ◽  
Vol 62 (8) ◽  
pp. 1160-1166
Author(s):  
Su Hwan Park ◽  
Min Seung Kang ◽  
Sang Yoon Kim ◽  
Ji-Eun Lee ◽  
Su Jin Kim
Keyword(s):  
Visual Acuity ◽  
Crohn’S Disease ◽  
Visual Field ◽  
Crohn's Disease ◽  
Optic Neuritis ◽  
Visual Field Defect ◽  
High Dose ◽  
Infliximab Treatment ◽  
Blurred Vision ◽  
Field Defect

Purpose: We report a case of optic neuritis related to infliximab treatment in a patient with Crohn’s disease, along with a review of the relevant literature.Case summary: A 22-year-male patient complained of blurred vision in the left eye for 2-3 weeks. His best-corrected visual acuity was 8/20 in the left eye. Relative afferent pupillary defect was detected in the left eye and the pupils were of equal size. There was no pain on ocular movement. The results of slit-lamp and fundus examinations were normal. A visual field test revealed a central to inferior visual field defect in the left eye. Orbit magnetic resonance imaging revealed perineural enhancement of the left optic nerve. He had a 5-year history of Crohn’s disease and had been treated with intravenous infliximab (600 mg every 2 weeks). A diagnosis of retrobulbar optic neuritis associated with infliximab was made. He was infused with high-dose methylprednisolone, which was changed to per oral administration. His visual acuity and visual field defect improved after 3 months.Conclusions: Tumor necrosis factor-α inhibitors, such as infliximab, may cause optic neuritis. Therefore, history-taking is important for differential diagnosis and appropriate treatment.

scholarly journals Novel technique of explantation of rigid phakic iris-claw lens and cataract extraction by sutureless manual small-incision surgery

2019 ◽  
Vol 12 (12) ◽  
pp. e233128
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon ◽  
Neha Mithal
Keyword(s):  
Visual Acuity ◽  
Cataract Extraction ◽  
Blurred Vision ◽  
Novel Technique ◽  
Small Incision ◽  
Complicated Cataract ◽  
Uncorrected Visual Acuity ◽  
Lens Surgery ◽  
Iris Claw Lens ◽  
Iris Claw

A 38-year-old patient presented to us with complaints of blurred vision and photophobia in the left eye with an uncorrected visual acuity of 20/400, improving to 20/60 with pinhole. The patient underwent phakic iris-claw lens surgery 15 years ago for high myopia. On examination, there was anterior chamber rigid phakic iris-claw lens along with complicated cataract. We planned for sutureless self-sealing 6.5 mm sclerocorneal tunnel for explantation of rigid phakic iris-claw lens along with cataract extraction with irrigating vectis. There was postoperative reduction in astigmatism due to incision planned on steep axis, and visual acuity improved to 20/30 uncorrected. This technique provides significant advantages from the previously described techniques in terms of decreased postop astigmatism, no need for sutures, no issues of chamber instability and iris trauma and without the need for phacoemulsification.

scholarly journals Cone Photoreceptor Structure in Patients With X-Linked Cone Dysfunction and Red-Green Color Vision Deficiency

2016 ◽  
Vol 57 (8) ◽  
pp. 3853 ◽  
Author(s):  
Emily J. Patterson ◽  
Melissa Wilk ◽  
Christopher S. Langlo ◽  
Melissa Kasilian ◽  
Michael Ring ◽  
...  
Keyword(s):  
Color Vision ◽  
Cone Photoreceptor ◽  
Color Vision Deficiency ◽  
Green Color ◽  
Cone Dysfunction

RETINAL TOXICITY OF HIGH DOSE INTRAVITREAL GANCICLOVIR

Retina ◽  
1994 ◽  
Vol 14 (3) ◽  
pp. 248-252 ◽  
Author(s):  
BRUCE R. SARAN ◽  
ALBERT M. MAGUIRE
Keyword(s):  
Retinal Toxicity ◽  
High Dose

scholarly journals Visual Acuity, Contrast Sensitivity and Color Vision Three Years After Iodine-125 Brachytherapy for Choroidal and Ciliary Body Melanoma

2015 ◽  
Vol 9 (1) ◽  
pp. 131-135 ◽  
Author(s):  
Irena Tsui ◽  
Robert M Beardsley ◽  
Tara A McCannel ◽  
Scott C Oliver ◽  
Melissa W Chun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Color Vision ◽  
Ciliary Body ◽  
Case Series ◽  
Vision Measurement ◽  
Corrected Visual Acuity ◽  
Iodine 125 ◽  
Decrease In Visual Acuity ◽  
Ciliary Body Melanoma

Purpose : To report visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after iodine-125 brachytherapy for choroidal and ciliary body melanoma (CCM). Design : Prospective interventional case series. Participants : Thirty-seven patients (37 eyes) with CCM. Methods : Patients had best-corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, Pelli-Robson contrast sensitivity and Hardy-Rand-Rittler color vision measurement; comprehensive ophthalmology examination; optical coherence tomography; and ultrasonography at baseline prior to, 1 year after, 2 years after and 3 years after I-125 brachytherapy. Main Outcome Measures : Visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after brachytherapy. Results : Nineteen (19) men and 18 women with mean age of 58 years (SD 13, range 30-78) prior to, 1 year after, 2 years after and 3 years after brachytherapy had mean best-corrected visual acuity of 77 letters (20/32), 65 letters (20/50), 56 letters (20/80) and 47 letters (20/125); contrast sensitivity of 30, 26, 22 and 19 letters; color vision of 26, 20, 17 and 14 test figures, respectively. Decrease in visual acuity, contrast sensitivity and color vision was statistically significant from baseline at 1 year, 2 years, and 3 years after brachytherapy. Decreased acuity at 3 years was associated with mid-choroid and macula melanoma location, ≥ 4.1 mm melanoma height, radiation maculopathy and radiation optic neuropathy. Conclusion : 1, 2 and 3 years after brachytherapy, eyes with CCM had significantly decreased visual acuity, contrast sensitivity and color vision.

scholarly journals A woman with visual loss, amenorrhoea and polyuria: the first reported case of nodular lymphocyte-predominant Hodgkin lymphoma presenting with hypopituitarism

2021 ◽  
Vol 2021 ◽  
Author(s):  
Matthew Seymour ◽  
Thomas Robertson ◽  
Jason Papacostas ◽  
Kirk Morris ◽  
Jennifer Gillespie ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Visual Loss ◽  
Post Partum ◽  
Bone Lesion ◽  
Optic Chiasm ◽  
High Dose ◽  
List Type ◽  
Sellar Mass ◽  
Blurred Vision ◽  
Surgical Biopsy

Summary A 34-year-old woman presented 18 months post-partum with blurred vision, polyuria, amenorrhoea, headache and general malaise. Comprehensive clinical examination showed left superior temporal visual loss only. Initial investigations revealed panhypopituitarism and MRI demonstrated a sellar mass involving the infundibulum and hypothalamus. Lymphocytic hypophysitis was suspected and high dose glucocorticoids were commenced along with desmopressin and thyroxine. However, her vision rapidly deteriorated. At surgical biopsy, an irresectable grey amorphous mass involving the optic chiasm was identified. Histopathology was initially reported as granulomatous hypophysitis. Despite the ongoing treatment with glucocorticoids, her vision worsened to light detection only. Histopathological review revised the diagnosis to partially treated lymphoma. A PET scan demonstrated avid uptake in the pituitary gland in addition to splenic involvement, lymphadenopathy above and below the diaphragm, and a bone lesion. Excisional node biopsy of an impalpable infraclavicular lymph node confirmed nodular lymphocyte-predominant Hodgkin lymphoma. Hyper-CVAD chemotherapy was commenced, along with rituximab; fluid-balance management during chemotherapy (with its requisite large fluid volumes) was extremely complex given her diabetes insipidus. The patient is now in clinical remission. Panhypopituitarism persists; however, her vision has recovered sufficiently for reading large print and driving. To the best of our knowledge, this is the first reported case of Hodgkin lymphoma presenting initially as hypopituitarism. Learning points Lymphoma involving the pituitary is exceedingly rare and, to the best of our knowledge, this is the first reported case of nodular lymphocyte-predominant Hodgkin lymphoma presenting as hypopituitarism. There are myriad causes of a sellar mass and this case highlights the importance of reconsidering the diagnosis when patients fail to respond as expected to appropriate therapeutic intervention. This case highlights the difficulties associated with managing panhypopituitary patients receiving chemotherapy, particularly when this involves large volumes of i.v. hydration fluid.

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