Chemotherapy-induced cystoid macular edema in ovarian cancer

Cystoid macular edema is a rare adverse event induced by chemotherapy that significantly reduces patient’s quality of life; however, symptoms of visual abnormalities may be indistinguishable from age-related changes. The authors report a case of cystoid macular edema that occurred during chemotherapy for recurrent ovarian cancer. The patient was treated with paclitaxel and carboplatin for six months; however, because of increased tumor size, the authors switched to paclitaxel and bevacizumab. Visual disturbance appeared about one month after the switch. The patient was diagnosed with cystoid macular edema and requested a change in her treatment regimen because of other adverse events, and the macular edema improved within about two months after the change.

Cystoid macular edema; Ovarian cancer; Paclitaxel; Bevacizumab.

[1] Bassi E., Loizzi V., Furino C., Martino R., Alessio G., Cormio G., et al.: “Cystoid macular edema secondary to paclitaxel therapy for ovarian cancer: A case report”. Mol. Clin. Oncol., 2017, 7, 285.

[2] Chelala E., Arej N., Antoun J., Kourie H.R., Zaarour K., Kattan J., et al.: “Central Macular Thickness Monitoring after a Taxane-Based Therapy in Visually Asymptomatic Patients”. Chemotherapy, 2017, 62, 199.

[3] Yokoe T., Fukada I., Kobayashi K., Shibayama T., Miyagi Y., Ito Y., et al.: “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., 2017, 10, 605.

[4] Rao R.C., Choudhry N.: “Cystoid macular edema associated with chemotherapy”. CMAJ, 2016, 188, 216.

[5] Koo N.K., Kim Y.C.: “A case of paclitaxel-induced maculopathy treated with methazolamide”. Korean J. Ophthalmol., 2012, 26, 394.
[6] Hassall M.M., Andrew N.H.: “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., 2016, 2016, 1136.

[7] Kim E.C., Ryu H.W., Lee H.J., Kim M.S.: “Bevacizumab eye drops delay corneal epithelial wound healing and increase the stromal response to epithelial injury in rats”. Clin. Exp. Ophthalmol., 2013, 41, 694.

[8] Dwivedi R., Tiroumal S.: “Possible Efficacy of Topical Dorzolamide in The Treatment of Paclitaxel-Related Cystoid Macular Edema”. Retin. Cases Brief Rep., 2018, 12, 75.

[9] Sridhar J., Shahlaee A., Ehmann D., Samara W.A., Rahimy E., Chiang A., et al.: “En Face Optical Coherence Tomography and Optical Coherence Tomography Angiography Imaging of Taxane-Associated Cystoid Macular Edema”. Ophthalmic Surg. Lasers Imaging Retina, 2016, 47, 176.

[10] Nakao S., Ikeda Y., Emi Y., Ishibashi T.: “Possibility of Müller Cell Dysfunction as the Pathogenesis of Paclitaxel Maculopathy”. Ophthalmic Surg. Lasers Imaging Retina, 2016, 47, 81.

[11] Modi D., Dubovy S.R.: “Non-leaking Cystoid Maculopathy Secondary to Systemic Paclitaxel”. Ophthalmic Surg. Lasers Imaging Retina, 2013, 44, 183.

[12] Kuznetcova T.I., Cech P., Herbort C.P.: “The mystery of angiographically silent macular oedema due to taxanes”. Int. Ophthalmol., 2012, 32, 299.

[13] Georgakopoulos C.D., Makri O.E., Vasilakis P., Exarchou A.: “Angiographically silent cystoid macular oedema secondary to paclitaxel therapy”. Clin. Exp. Optom., 2012, 95, 233.