Oxaliplatin-induced papilledema: Rare case report

Area of Science:

• Ophthalmology
• Neurology
• Oncology

Background:

• Papilledema is optic disc swelling due to increased intracranial pressure, typically bilateral and symmetric.
• Chemotherapy, particularly platinum agents, can have various neurological side effects.
• Early identification of treatment-related adverse events is crucial for patient management.

Observation:

• A 70-year-old male with rectal carcinoma on oxaliplatin chemotherapy presented with bilateral disc edema and mild visual acuity decrease.
• Standard investigations, including neuroimaging and cerebrospinal fluid pressure measurement, were normal.
• No evidence of brain metastasis was detected, ruling out common causes of papilledema.

Findings:

• The patient's presentation suggests a potential association between oxaliplatin chemotherapy and the development of papilledema.
• Literature review revealed limited cases of platinum-based chemotherapy-induced papilledema, with no prior reports specifically implicating oxaliplatin.
• This case represents the first documented instance of oxaliplatin-induced papilledema.

Implications:

• Recognizing oxaliplatin-induced papilledema is vital for prompt diagnosis and intervention, potentially preventing vision loss in cancer patients.
• Oncologists and ophthalmologists should consider this rare adverse effect in patients on oxaliplatin presenting with optic disc edema.
• Further research is warranted to elucidate the mechanism and incidence of oxaliplatin-induced papilledema.