Posterior segment toxicity after gemcitabine and docetaxel chemotherapy

Area of Science:

• Ophthalmology
• Oncology
• Pharmacology

Background:

• Gemcitabine and docetaxel are commonly used chemotherapy agents for various cancers.
• Ocular side effects from chemotherapy can impact patient vision and treatment adherence.

Observation:

• A case of a 78-year-old woman experiencing blurry vision after gemcitabine and docetaxel therapy for stage IV sarcoma.
• Ophthalmic examination revealed severe uveal effusion and outer retinal disruption, specifically affecting the photoreceptor inner segment ellipsoid band.
• Choroidal folds were also noted in the contralateral eye.

Findings:

• The patient's visual acuity improved significantly after weekly monitoring and continued gemcitabine monotherapy.
• B-scan ultrasonography and spectral domain optical coherence tomography were key diagnostic tools.
• Uveal effusion showed considerable improvement within 8 weeks of follow-up.

Implications:

• This case highlights the potential for gemcitabine and docetaxel combination therapy to induce significant ocular toxicity.
• Early ophthalmic detection and close monitoring are essential for managing chemotherapy-induced uveal effusion and retinal changes.
• Integrating ophthalmological surveillance may allow for continued cancer treatment while mitigating adverse ocular events.