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Published on: February 15, 2020
Cone damage in patients receiving high-dose irofulven treatment
Michael S Lee1, Nisha Gupta, Richard T Penson
1Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44124, USA. leem4@ccf.org
Objectives:
To describe the clinical, perimetric, and electroretinographic (ERG) results of 4 patients with cone dysfunction following irofulven treatment including the histopathologic and immunocytochemical features of one patient's retinas.
Design:
Observational case series.
Methods:
The patients were examined clinically, including perimetric and ERG evaluations. Eyes from patient 1 and healthy postmortem eyes were processed for histopathologic and immunocytochemistry studies with antibodies specific for cones, rods, and reactive Müller cells.
Main Outcome Measures:
Clinical signs and symptoms, perimetry, ERG, retinal histopathologic and immunocytochemistry study results.
Results:
All 4 patients had ERG changes consistent with abnormal cone responses and relatively normal rod responses. Compared with control eyes, the retina of patient 1 had approximately half the normal numbers of macular cones and fewer peripheral cones. The number of rods were normal but all rod and cone outer segments were shortened.
Conclusion:
High-dose irofulven treatment causes cone-specific damage with relative sparing of rods.
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