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Retinal toxicities of systemic anticancer drugs
Survey of Ophthalmology ( IF 5.1 ) Pub Date : 2021-05-26 , DOI: 10.1016/j.survophthal.2021.05.007
Supriya Arora 1 , Thamolwan Surakiatchanukul 2 , Tarun Arora 3 , Marie Helene Errera 4 , Hitesh Agrawal 5 , Marco Lupidi 6 , Jay Chhablani 7
Affiliation  

Newer anticancer drugs have revolutionized cancer treatment in the last decade, but conventional chemotherapy still occupies a central position in many cancers, with combination therapy and newer methods of delivery increasing their efficacy while minimizing toxicities. We discuss the retinal toxicities of anticancer drugs with an emphasis on the mechanism of toxicity. Uveitis is seen with the use of v-raf murine sarcoma viral oncogene homolog B editing anticancer inhibitors as well as immunotherapy. Most of the cases are mild with only anterior uveitis, but severe cases of posterior uveitis, panuveitis, and Vogt-Koyanagi-Harada-like disease may also occur. In the retina, a transient neurosensory detachment is observed in almost all patients on mitogen-activated protein kinase kinase (MEK) inhibitors. Microvasculopathy is often seen with interferon α, but vascular occlusion is a more serious toxicity caused by interferon α and MEK inhibitors. Crystalline retinopathy with or without macular edema may occur with tamoxifen; however, even asymptomatic patients may develop cavitatory spaces seen on optical coherence tomography. A unique macular edema with angiographic silence is characteristic of taxanes. Delayed dark adaptation has been observed with fenretinide. Interestingly, this drug is finding potential application in Stargardt disease and age-related macular degeneration.



中文翻译:

全身性抗癌药物的视网膜毒性

较新的抗癌药物在过去十年中彻底改变了癌症治疗,但传统化学疗法仍然在许多癌症中占据中心位置,联合疗法和更新的递送方法提高了它们的疗效,同时最大限度地减少了毒性。我们讨论了抗癌药物的视网膜毒性,重点是毒性机制。葡萄膜炎见于使用 v-raf 鼠肉瘤病毒癌基因同源物 B 编辑抗癌抑制剂以及免疫疗法。多数情况较轻,仅有前葡萄膜炎,但也可能出现后葡萄膜炎、全葡萄膜炎和 Vogt-Koyanagi-Harada 样疾病的严重病例。在视网膜中,几乎所有使用有丝分裂原活化蛋白激酶激酶 (MEK) 抑制剂的患者都观察到短暂的神经感觉脱离。微血管病变常见于干扰素α,但血管阻塞是干扰素α和MEK抑制剂引起的更严重的毒性。他莫昔芬可能会出现伴有或不伴有黄斑水肿的结晶性视网膜病变;然而,即使是无症状的患者也可能出现在光学相干断层扫描上可见的空洞空间。具有血管造影沉默的独特黄斑水肿是紫杉烷类的特征。使用芬维A胺观察到延迟的暗适应。有趣的是,这种药物在 Stargardt 病和年龄相关性黄斑变性中发现了潜在的应用。即使是无症状的患者也可能出现在光学相干断层扫描上可见的空洞空间。具有血管造影沉默的独特黄斑水肿是紫杉烷类的特征。使用芬维A胺观察到延迟的暗适应。有趣的是,这种药物在 Stargardt 病和年龄相关性黄斑变性中发现了潜在的应用。即使是无症状的患者也可能出现在光学相干断层扫描上可见的空洞空间。具有血管造影沉默的独特黄斑水肿是紫杉烷类的特征。使用芬维A胺观察到延迟的暗适应。有趣的是,这种药物在 Stargardt 病和年龄相关性黄斑变性中发现了潜在的应用。

更新日期:2021-05-26
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