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  • Küçük Resim Yok
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    Assessment of ocular neurotoxicity in patients treated with systemic cancer chemotherapeutics
    (2014) Bakbak B.; Gedik S.; Koktekir B.E.; Yavuzer K.; Tulek B.; Kanat F.; Pancar E.
    Purpose: Cisplatin and Paclitaxel are two chemotherapeutic agents known to produce neurotoxicity when used for cumulative dose regimens. In this study we aim to assess their toxicity in the optic nerve, and to evaluate the retinal nerve fibre layer (RNFL) thickness and visual field changes in lung cancer patients treated with Cisplatin and Paclitaxel. Methods: Fifteen patients who were treated intravenously with 75mg/m2 cisplatin and 175mg/m 2 paclitaxel every 3 weeks, up to a maximum of six courses, were enrolled in this prospective clinical trial. All patients underwent complete ophthalmological assessments before their treatments began, as well as three months after the completion of their treatments. The RNFL thickness measurements were performed using optical coherence tomography (OCT). Functional testing included the use of frequency-doubling technology (FDT) perimetry and the Humphrey visual field analyser (HFA). The main outcome measurements included the average RNFL thicknesses and visual field indices (mean deviation [MD] and pattern standard deviation [PSD]). Results: The median age of the 15 patients (nine male and six female) was 63.49 years old (range: 53-77). The average RNFL thickness measurement during the baseline examination was 103.73?m (range: 97-111). Three months after the cessation of treatment the RNFL thickness declined to 97.4?m (range: 91-102). Statistical analysis showed a significant thinning between the two measurements (p=0.032). The MD and PSD values recorded by the HFA demonstrated no statistically significant changes 3 months after the cessation of treatment (p>0.207 and p>0.186, respectively). There were statistically significant decreases in both the MD (0.48 to-1.13dB) and PSD (2.13 to 0.65dB) indices measured by the FDT perimetry (p=0.041 and p=0.025, respectively). Conclusions: In our study, the systemic administration of Cisplatin and Paclitaxel affected the peripapillary RNFL thicknesses and visual field indices as revealed by FDT perimetry. OCT and FDT perimetry may be adjunctive tools for the screening of ocular toxicity in patients treated with these agents. © 2014 Informa Healthcare USA, Inc.
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    Can intramuscular corticosteroid injection cause nonarteritic anterior ischemic optic neuropathy?
    (2013) Bakbak B.; Ozturk B.T.; Gedik S.; Koktekir B.E.; Gonul S.
    A 56-year-old man noted a sudden decrease of vision in his right eye 4 hours after intramuscular triamcinolone acetonide (TA) injection. A diagnosis of unilateral nonarteritic anterior ischemic optic neuropathy (NAION) was made, and the patient was counseled to discontinue using TA. Examination for possible risk factors revealed controlled hypertension. Final visual acuity was finger counting at 1 m, and the optic disc was pale in his right eye. This is the first reported case of unilateral NAION that has occurred in a patient after intramuscular corticosteroid injection. Although a cause-and-effect relationship is difficult to prove, the short duration between the TA injection and the NAION is noteworthy. The history of corticosteroid injection should be questioned in cases with predisposing conditions such as hypertension. © 2013 Bakbak et al, publisher and licensee Dove Medical Press Ltd.