Skip to main content

Advertisement

SpringerLink
Log in

Optical coherence tomography characteristics of taxane-induced macular edema and other multimodal imaging findings

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To identify common optical coherence tomography (OCT) characteristics of taxane-related CME (T-CME) to differentiate it from CME associated with other causes (O-CME) and to present multimodal imaging findings of T-CME.

Methods

To differentiate T-CME from O-CME, pooled SD-OCT images from 14 previous publications and images obtained from our multicenter case series of 3 patients with multimodal imaging of T-CME were compared with 16 consecutive cases of O-CME. Images were graded by 2 masked retinal specialists based on the presence of pre-specified OCT characteristics such as CME centered around fovea, outer retinal cysts more prominent compared with inner retinal cysts, continuous outer plexiform layer (OPL) and inner plexiform layer (IPL), intact outer retina layer, attenuation of outer retina layers by overlying retinal layers, and the presence of subretinal fluid.

Results

Comparing 19 and 16 SD-OCT images of T-CME and O-CME, respectively, T-CME showed a significantly higher rate of the continuous OPL and IPL layer and a higher composite score of the various pre-specified OCT features. All other individual features showed no significant difference between T-CME and O-CME. All our patients had T-CME that had vague petalloid patterns on the late-stage FFA, with late leakage on ICGA. OCT angiography in one case showed an intact foveal avascular zone.

Conclusions

T-CME is a rare but important complication of taxane chemotherapy. Specific OCT features such as an intact continuous OPL and IPL layer combined with other OCT features can help distinguish T-CME from O-CME, and early diagnosis is clinically important as cessation of taxanes before the retinal layers are disrupted may prevent permanent vision loss.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Yokoe T, Fukada I, Kobayashi K et al (2017) Cystoid macular edema during treatment with paclitaxel and bevacizumab in a patient with metastatic breast cancer: a case report and literature review. Case Rep Oncol 10(2):605–612

    Article  PubMed  PubMed Central  Google Scholar 

  2. Eisner A, Luoh S (2011) Breast cancer medications and vision: effects of treatments for early-stage disease. Curr Eye Res 36(10):867–885

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Hofstra L, de Vries E, Willemse P (1997) Ophthalmic toxicity following paclitaxel infusion. Ann Oncol 8(10):1053–1053

    Article  CAS  PubMed  Google Scholar 

  4. Li J, Tripathi R, Tripathi B (2008) Drug-induced ocular disorders. Drug Saf 31(2):127–141

    Article  PubMed  Google Scholar 

  5. Teitelbaum B, Tresley D (2003) Cystic maculopathy with normal capillary permeability secondary to docetaxel. Optom Vis Sci 80(4):277–279

    Article  PubMed  Google Scholar 

  6. Joshi M (2007) Paclitaxel maculopathy. Arch Ophthalmol 125(5):709

    Article  PubMed  Google Scholar 

  7. Koo N, Kim Y (2012) A case of paclitaxel-induced maculopathy treated with methazolamide. Korean J Ophthalmol 26(5):394

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ehlers J, Rayess H, Steinle N (2012) Topical dorzolamide therapy for taxane-related macular oedema. Eye. 27(1):102–104

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ham D, Lee J, Kim H, Yun I (2012) A case of cystoid macular edema associated with paclitaxel chemotherapy. Korean J Ophthalmol 26(5):388

    Article  PubMed  PubMed Central  Google Scholar 

  10. Murphy C, Walsh J, Hudis C, Lake D, Theodoulou M (2010) Cystoid macular edema secondary to nab-paclitaxel therapy. J Clin Oncol 28(33):e684–e687

    Article  PubMed  Google Scholar 

  11. Kuznetcova TI, Cech P, Herbort CP (2012) The mystery of angiographically silent macular oedema due to taxanes. Int Ophthalmol 32(3):299–304

    Article  PubMed  Google Scholar 

  12. Matsuoka N, Hasebe H, Mayama T, Fukuchi T (2015) Sub-tenon injections of triamcinolone acetonide had limited effect on cystoid macular edema secondary to nanoparticle albumin-bound paclitaxel (abraxane). Case Rep Ophthalmol Med 2015:1–4

    Google Scholar 

  13. Freitas-da-Costa P, Brandão E, Bragança T, Falcão-Reis F, Carneiro A (2015) Multimodal imaging in paclitaxel-induced macular edema: the microtubule disfunction. Cutan Ocul Toxicol 34(4):347–349

    Article  CAS  PubMed  Google Scholar 

  14. Hassall MM, Andrew NH (2016) Single-eye trial of a topical carbonic anhydrase inhibitor versus intravitreal bevacizumab for the treatment of taxane drug-induced cystoid macula oedema. BMJ Case Rep. https://doi.org/10.1136/bcr2015212733

  15. Shih C-H, Lee Y-C (2018) Impaired retinal pigment epithelium in paclitaxel-induced macular edema. Medicine 97(26):e11229

    Article  PubMed  PubMed Central  Google Scholar 

  16. Telander DG, Sarraf D (2007) Cystoid macular edema with docetaxel chemotherapy and the fluid retention syndrome. Semin Ophthalmol 22(3):151–153

    Article  PubMed  Google Scholar 

  17. Semb K, Aamdal S, Oian P (1998) Capillary protein leak syndrome appears to explain fluid retention in cancer patients who receive docetaxel treatment. J Clin Oncol 16(10):3426–3432

    Article  CAS  PubMed  Google Scholar 

  18. Spirn M, Warren F, Guyer D, Klancnik J, Spaide R (2003) Optical coherence tomography findings in nicotinic acid maculopathy. Am J Ophthalmol 135(6):913–914

    Article  PubMed  Google Scholar 

  19. Coscas G, Loewenstein A, Cunha-Vaz J, Soubrane G (2017) Macular edema, 2nd edn. S. Karger Ag, Basel, pp 1–10

    Book  Google Scholar 

  20. Makri OE, Georgalas I, Georgakopoulos CD (2013) Drug-induced macular edema. Drugs. 73(8):789–802

    Article  CAS  PubMed  Google Scholar 

  21. Bassi E, Loizzi V, Furino C et al (2017) Cystoid macular edema secondary to paclitaxel therapy for ovarian cancer: a case report. Mol Clin Oncol 7(2):285–287

    Article  PubMed  PubMed Central  Google Scholar 

  22. Nomi N, Ota M, Fukumura M et al (2017) Indocyanine green angiography findings of cystoid macular edema secondary to paclitaxel therapy. Jpn J Ophthalmol 62(2):163–167

    Article  PubMed  Google Scholar 

  23. Chelala E, Arej N, Antoun J et al (2017) Central macular thickness monitoring after a taxane-based therapy in visually asymptomatic patients. Chemotherapy. 62(3):199–204

    Article  CAS  PubMed  Google Scholar 

  24. Crabtree DV, Ojima I, Geng X, Adler AJ (2001) Tubulins in the primate retina: evidence that xanthophylls may be endogenous ligands for the paclitaxel-binding site. Bioorg Med Chem 9(8):1967–1976

    Article  CAS  PubMed  Google Scholar 

  25. Meyer K, Klink T, Ugurel S, Bröcker E (2011) Regression of paclitaxel-induced maculopathy with oral acetazolamide. Graefes Arch Clin Exp Ophthalmol 250(3):463–464

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, Singapore

    Joel M. Perez, Kelvin Teo, Ricardo Ong & Anna C. S. Tan

  2. Singapore Eye Research Institute, Singapore, Singapore

    Joel M. Perez, Kelvin Teo, Ricardo Ong & Anna C. S. Tan

  3. Duke-NUS Medical School, Singapore, Singapore

    Kelvin Teo & Anna C. S. Tan

  4. Yokohama City University Medical Center, Yokohama, Japan

    Maiko Maruyama-Inoue

  5. Vitreous Retina Macula Consultants of New York, New York, NY, USA

    K. Bailey Freund

  6. The LuEsther T. Mertz Retinal Research Center, New York, NY, USA

    K. Bailey Freund

  7. Department of Ophthalmology, New York University School of Medicine, New York, NY, USA

    K. Bailey Freund

Authors
  1. Joel M. Perez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kelvin Teo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ricardo Ong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maiko Maruyama-Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Bailey Freund
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anna C. S. Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AT and JP developed the study design, conducted the analysis, and prepared the manuscript and figures; KT and RO performed the analysis; MM and KBF were the senior authors who provided the cases, edited and reviewed the manuscript, and provided the scientific expert advice on the manuscript.

Corresponding author

Correspondence to Anna C. S. Tan.

Ethics declarations

Conflict of interest

AT speaks and receives sponsorship for Zeis, Nidek, Bayer, and Novartis and travel grants from Allergan and Mandarin Optics. KBF is a consultant to Genentech, Optovue, Zeiss, Heidelberg Engineering, Allergan, and Novartis.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Health Insurance Portability and Accountability Act of 1996 and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 19.5 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Perez, J.M., Teo, K., Ong, R. et al. Optical coherence tomography characteristics of taxane-induced macular edema and other multimodal imaging findings. Graefes Arch Clin Exp Ophthalmol 258, 1607–1615 (2020). https://doi.org/10.1007/s00417-020-04755-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-020-04755-z

Keywords

Search

Navigation