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Persistent severe visual and electroretinographic abnormalities after intravenous Cisplatin therapy
Bradley J Katz1, John H Ward, Kathleen B Digre
1John A Moran Eye Center, University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA. bradley.katz@hsc.utah.edu
Summary
A patient experienced irreversible vision loss after receiving an excessive dose of cisplatin chemotherapy. Ocular examination revealed abnormalities consistent with cisplatin toxicity, highlighting a rare adverse effect.
Area of Science:
- Ophthalmology
- Oncology
- Neuroscience
Background:
- Cisplatin is a platinum-based chemotherapy agent used for various cancers.
- High-dose chemotherapy can lead to severe adverse effects, including neurotoxicity.
- Ocular toxicity from cisplatin is rare but can be devastating.
Observation:
- A 55-year-old man received four times the intended dose of intravenous cisplatin.
- He developed immediate bilateral irreversible visual loss with central scotomas.
- Fundus examination was normal, but electroretinogram showed reduced a-wave and absent b-wave amplitudes.
Findings:
- Autopsy revealed normal photoreceptors but splitting of the outer plexiform layer.
- Histopathology correlated with the electroretinogram findings of absent b-waves.
- This case is the first report of persistent visual loss from intravenous cisplatin toxicity.
Implications:
- This case highlights a severe, potentially irreversible ocular complication of high-dose cisplatin.
- It underscores the importance of careful dose monitoring in chemotherapy.
- Further research into the mechanisms of cisplatin-induced ocular toxicity is warranted.