A Case of Oxaliplatin-Related Ocular Toxicity

Han Seok Park; Yang Jae Kim; Su Jeong Song; Jeong Hun Bae

doi:10.3341/jkos.2014.55.1.143

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Park, Kim, Song, and Bae: A Case of Oxaliplatin-Related Ocular Toxicity

Original Article

J Korean Ophthalmol Soc 2014;55(1):143-148.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.1.143

A Case of Oxaliplatin-Related Ocular Toxicity

Han Seok Park, MD, Yang Jae Kim, MD, Su Jeong Song, MD, Jeong Hun Bae, MD

Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Jeong Hun Bae, MD Department of Ophthalmology, Kangbuk Samsung Medical Center, #29 Saemunan-ro, Jongno-gu, Seoul 110-746, Korea, Tel: 82-2-2001-2250, Fax: 82-2-2001-2262, E-mail: jhbae94@hotmail.com

Received 8 July 20136 August 2013 Accepted 1 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of oxaliplatin (Eloxatin^®)-related ocular toxicity in a patient with advanced stomach cancer.

Case summary

A 43-year-old female with advanced stomach cancer experienced visual symptoms during the treatment with oxaliplatin on a XELOX schedule (a combination of oxaliplatin and capecitabine). After 1 cycle of chemotherapy, she complained of blurred vision and visual field defects in both eyes. Visual field tests showed a bilateral concentric field defect and the electroretinogram revealed a marked reduction of responses in both eyes. On the second cycle of chemo-therapy, oxaliplatin was discontinued due to suspicious ocular toxicity. Her visual symptoms improved and visual field test showed normal results 1 month after oxaliplatin discontinuation. However, 3 months after oxaliplatin discontinuation, electroretinogram remained abnormal despite the progressive improvement.

Conclusions

Platinum-based antineoplastic agents such as oxaliplatin should be administered with caution because oxaliplatin can cause damage to the retinal photoreceptors and the optic nerve. Early detection of ocular toxicity and dis-continuation of oxaliplatin therapy could prevent severe and irreversible visual loss.

Keywords: Electroretinogram, Ocular toxicity, Oxaliplatin, XELOX

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Figure 1.

Fundus photographs show no alteration in the retina or optic disc. Focal depigmentation on the macula of the right eye is an old lesion previously detected during health examinations 2 years ago.

Figure 2.

(A) Visual evoked potential (VEP) and (B) Electrooculogram (EOG) at first visit. VEP and EOG reveal normal results in both eyes.

Figure 3.

(A) Visual field performed before the cessation of oxaliplatin showed a bilateral concentric visual field defect with enlarged blind spot and diminished light sensitivity. (B) After 3 months without oxaliplatin, the visual field shows improvement in both eyes.

Figure 4.

Electroretinogram (ERG). At first visit, full-field ERG showed deeply reduced responses with normal implicit time in both eyes. After 3 months without oxaliplatin, ERG responses recover mildly, but still remain abnormal.

Figure 5.

Optical coherence tomography (OCT). Macular OCT are normal in both eyes.

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