Nab-Paclitaxel-Induced Cystoid Macular Edema with Minimal Fluorescein Leakage: A Case Report of Two Patients from a Tertiary Referral Center.

IF 0.6 Q4 OPHTHALMOLOGY

Case Reports in Ophthalmology Pub Date : 2026-06-27 eCollection Date: 2026-01-01 DOI:10.1159/000553334

Mariko Kawata, Yuki Saeki, Kazuki Yashiro, Mami Ota, Shuichiro Aoki, Kohdai Kitamoto, Ryo Terao, Keiko Azuma

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引用次数: 0

Abstract

Introduction: The aim of the study was to report 2 cases of nab-paclitaxel (nab-PTX)-induced macular edema and describe its incidence over a 5-year period at a tertiary center.

Case presentations: We retrospectively reviewed patients who received nab-PTX between July 2020 and June 2025 across several departments at our institution. Ophthalmic findings, multimodal imaging results, management, and outcomes were analyzed. Among 183 patients treated with nab-PTX, 25 symptomatic patients were referred to ophthalmology, and 2 were adjudicated as definite taxane-induced macular edema (TIME; observed proportion, 2/183; 1.1%). Both patients were men with metastatic pancreatic cancer receiving gemcitabine and nab-PTX. Optical coherence tomography (OCT) demonstrated bilateral cystoid macular edema. In Case 1, fluorescein angiography (FA) showed no macular leakage or vasculitis. Central retinal thickness (CRT) improved from 479/582 µm (right/left) to 175/173 µm after discontinuation of therapy, with macular edema resolving by 11 weeks. In Case 2, FA was not performed because of the patient's poor general condition; OCT angiography showed no microaneurysms or other findings suggestive of alternative causes of macular edema. CRT improved from 659/663 µm to 207/232 µm at 1 month after discontinuation, with complete resolution by 3 months. Best-corrected visual acuity improved in both cases after nab-PTX discontinuation.

Conclusion: Nab-PTX can cause bilateral cystoid macular edema, often with minimal or absent FA leakage, and treatment discontinuation can lead to anatomical and functional recovery. Early recognition and prompt interdisciplinary management are important to prevent potentially irreversible visual impairment. Because ophthalmologic evaluation was symptom-driven, asymptomatic, or mildly symptomatic, TIME may have been underdetected; therefore, this observed proportion should not be interpreted as a population-level incidence estimate.

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nab -紫杉醇诱导的囊样黄斑水肿伴微量荧光素渗漏：来自三级转诊中心的两例患者的病例报告。

本研究的目的是报告2例nab-紫杉醇（nab-PTX）诱导的黄斑水肿，并描述其在三级中心5年期间的发病率。病例介绍：我们回顾性分析了我院多个科室在2020年7月至2025年6月期间接受nab-PTX治疗的患者。分析眼科检查结果、多模态影像学结果、治疗方法和结果。在接受nab-PTX治疗的183例患者中，25例有症状的患者转诊眼科，2例确诊为紫杉烷性黄斑水肿（TIME；观察比例，2/183;1.1%）。两例患者均为接受吉西他滨和nab-PTX治疗的转移性胰腺癌患者。光学相干断层扫描（OCT）显示双侧黄斑囊样水肿。病例1，荧光素血管造影（FA）未显示黄斑渗漏或血管炎。停止治疗后，视网膜中央厚度（CRT）从479/582µm（右/左）改善到175/173µm，黄斑水肿消退11周。在病例2中，由于患者一般情况较差，未行FA；OCT血管造影未发现微动脉瘤或其他提示黄斑水肿其他原因的发现。停用后1个月，CRT从659/663µm改善到207/232µm， 3个月完全分辨率。停用nab-PTX后，两例患者的最佳矫正视力均有改善。结论：Nab-PTX可引起双侧黄斑囊样水肿，常伴有少量或无FA渗漏，停止治疗可导致解剖和功能恢复。早期识别和及时的跨学科管理对于预防潜在的不可逆转的视力损害至关重要。由于眼科评估是由症状驱动的、无症状的或轻度症状的，TIME可能未被发现；因此，这一观察到的比例不应被解释为人口水平的发病率估计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Ophthalmology OPHTHALMOLOGY-

CiteScore

0.90

自引率

0.00%

发文量

129

审稿时长

12 weeks

期刊介绍： This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.