Nab-Paclitaxel related cystoid macular edema
V. 173 N. 4 (2022), Review
V. 173 N. 4 (2022)

Nab-Paclitaxel related cystoid macular edema: doi: 10.7417/CT.2022.2449

Review
Pubblicato 2022-07-20
M. Di Pippo
Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, University of Rome Sapienza
F. Di Staso
Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, University of Rome Sapienza, St. Andrea Hospital, Rome, Italy
C. De Ponte
Pharmacy Unit, INMI Lazzaro Spallanzani, Rome Italy
S. Fragiotta
Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, University of Rome Sapienza, St. Andrea Hospital, Rome, Italy
S. Abdolrahimzadeh
Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, University of Rome Sapienza, St. Andrea Hospital, Rome, Italy
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Parole chiave

cystoid macular edema
dorzolamide
intravitreal dexamethasone
multimodal imaging
nab-paclitaxel
spectral domain-optical coherence tomography

Abstract

Objectives: Nab-paclitaxel is a chemotherapeutic drug used to treat various solid malignant tumors. It was conceived with a solvent free formulation to overcome toxicity events and hypersensitivity reactions associated with paclitaxel.However, it still carries ocular adverse effects. The present review examines nab-paclitaxel related cystoid macular edema (CME) and the available therapeutic options.

Materials and Methods: The literature was reviewed on nab-paclitaxel related CME on published articles through January 2021 using the keywords "nab-paclitaxel "and "cystoid macular edema".

Results: Bilateral CME is found inpatients in treatment with nab-paclitaxel and causes considerable visual acuity decline. In ophthalmology multimodal imaging has an integral role in the diagnostic work up of patients and shows characteristic findings in nab-paclitaxelrelated CME. The case of a patient with treatment for bilateral CME is presented and analyzed.

Conclusions: The preferred management strategy for nab-paclitaxel-related CME is drug cessation that leads tocomplete resolution of edema. When discontinuation of treatment is not possible due to the systemic conditions of patients, effective alternative therapeutic modalities are topical dorzolamide or steroidal treatment. Given the higher complication hazards of intravitreal therapy topical treatment should be preferred owing to comparable efficacy.

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