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Docetaxel-induced maculopathy possibly potentiated by concurrent hydroxychloroquine use
Abdelrahman M Elhusseiny1,2, Nidhi Relhan1, William E Smiddy1
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136, USA.
American Journal of Ophthalmology Case Reports
|October 26, 2019
Summary
This case report details docetaxel-induced maculopathy, a rare condition potentially worsened by hydroxychloroquine. The patient experienced vision loss, but the macular edema improved over time.
Area of Science:
- Ophthalmology
- Oncology
- Rheumatology
Background:
- Docetaxel chemotherapy is used for breast cancer treatment.
- Hydroxychloroquine is used for rheumatoid arthritis and can cause retinopathy.
- Macular edema is a known side effect of some chemotherapies.
Observation:
- A 63-year-old female on long-term hydroxychloroquine developed vision loss after docetaxel chemotherapy.
- Optical coherence tomography revealed bilateral cystic maculopathy without leakage.
- The patient had no prior retinopathy despite 33 years of hydroxychloroquine use.
Findings:
- This is the first reported case of docetaxel-induced maculopathy potentially potentiated by hydroxychloroquine.
- The non-leaking cystic maculopathy may result from impaired retinal pigment epithelial transport.
- Macular edema improved over 9 months, but visual acuity remained poor, possibly due to cataract.
Implications:
- Highlights a potential drug interaction between docetaxel and hydroxychloroquine affecting the macula.
- Suggests careful monitoring for maculopathy in patients receiving both medications.
- Underscores the importance of considering drug-induced maculopathy in differential diagnosis.
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