A cross-sectional optical coherence tomography study in patients on taxane-based therapy and a case report with the literature review

Purpose To evaluate the characteristics of macular retinal and subfoveal choroidal changes in patients already on taxane-based therapy by the help of spectral domain optical coherence tomograpy (SD-OCT) and determine the incidence of taxane- related cystoid macular edema (CME). Materials and methods In this cross-sectional case-control study, 202 patients who received taxane-based therapy due to treatment of various cancer and age and sex-matched 200 healthy control subjects were examined. Only patients who received at least 4 cycles of taxane-based therapy were taken into consideration for the taxane group. Taxane-based therapy was further divided into two subgroups; paclitaxel group (149 patients) and docetaxel group (53 patients). Central macular thickness (CMT) and central subfoveal choroidal thickness (CCT) were measured just once during their ongoing chemotherapy using SD-OCT and enhanced-depth imaging (EDI) OCT by Heidelberg OCT by a single examiner. Results Patients received a median of 7 cycles (range, 4-26) of paclitaxel or docetaxel and received a total cumulative dose of 852.81 +/- 368.82 mg/m(2)(range, 300-2310 mg/m(2)). Though the mean CMT was significantly thicker in the taxane group (224.9 +/- 28.4 mu m) than the healthy control group (215.9 +/- 19.7 mu m), there was no statistically significant difference between the paclitaxel (225.3 +/- 28.2 mu m) and docetaxel (224.2 +/- 20.1 mu m) groups. On the other hand, the CCT was not statistically significant different between the taxane versus control eyes and paclitaxel versus docetaxel patients. Taxane-related CME was detected only in one patient on paclitaxel. Overall, incidence of taxane-related maculopathy was 0.5% (1/202) of all patients in the taxane group. Conclusion In our group of taxane receiving patients, incidence of taxane-related CME was 0.5%. In light of our study, we believe that clinicians should be alert on the occurence of taxane-related CME and carefully scrutinize the patients whenever any suspicion is arisen.