Unraveling the Mystery of Taxol-Induced Cystoid Macular Oedema: Case Report and Literature Review.

Abstract

Objectives: The primary aim of this article is to present cystoid macular oedema as one of the side effects of Paclitaxel (Taxol) chemotherapy. Paclitaxel is used as a treatment option in patients with different types of solid carcinomas. The potential loss of vision, already altered by the disease, further compromises their quality of life, a contributing factor to overall psychological and mental decline.

Case presentation: A 69-year-old woman developed a drop in visual acuity that was painless, bilateral, and accompanied by wavy lines. This occurred six months after starting Paclitaxel chemotherapy for metastatic breast cancer. The diagnosis of cystoid macular oedema caused by Paclitaxel was made. The visual acuity significantly improved after Paclitaxel was discontinued, and the symptoms subsided.

Discussion: Paclitaxel is a chemotherapy drug used to treat various types of cancers and has been associated with cystoid macular oedema (CMO) in rare cases. CMO is thought to result from the disruption of the normal blood-retinal barrier. The specific mechanism remains incompletely understood, and multiple mechanisms have been postulated. In typical CMO, leakage from parafoveal capillaries is demonstrated on fluorescein angiograms in a classic petaloid pattern. However, in Taxane-Drug Induced CMO (TDICMO), there is no evidence of fluorescein leakage on angiography. TDICMO is a rare drug side effect of breast cancer treatment, described just 14 times in the English literature.

Conclusion: It is crucial to reiterate that if a patient undergoing Paclitaxel treatment experiences any vision changes, it is imperative to consult an ophthalmologist for a thorough evaluation and appropriate management. This step is essential for the patient's well-being and to ensure the best possible outcome.