Topical ciprofloxacin induced ocular toxicity: case report

Ciprofloxacin is a commonly used fluoroquinolone group of antimicrobial which is used for treating infective conditions like community acquired pneumonia and urinary tract infections. A patient of cataract was treated with ciprofloxacin eye drop as her pre-operative medication. She presented after four days with itching and redness in her right eye with swelling of the peri-orbital skin. We report this rare case where topical application of ciprofloxacin was responsible for the ocular symptoms.

A rare case: Branch retinal vein occlusion associated with the use of tamoxifen

Tamoxifen-induced ocular complications including cataracts, keratopathies, retinopathy, impaired visual acuity, ocular irritation, optical neuritis, and retinal vein occlusion are uncommonly reported in the literature. Herein, we report on a premenopausal patient with right-side breast carcinoma who received adjuvant tamoxifen therapy (20 mg/day) for 1.5 years and developed sudden visual loss. Fundal examination revealed an obstruction in the branch of the retinal vein. The diagnosis was confirmed by fluorescein angiography and optical coherence tomography. Thus, tamoxifen was switched to an aromatase inhibitor. Tamoxifen-induced ocular complications should be kept in mind when visual symptoms are seen in patients undergoing tamoxifen therapy. In such cases, a complete ocular examination should be performed

Pay more attention to drug-induced ocular toxicity / 中华实验眼科杂志

Medication safety is one of the primary considerations in drug therapy.With the increase of drug categories and the diversification of drug delivery routes,more and more attention has been paid to ocular adverse events caused by topical and systemic administration.Topical administration can directly induce toxicity to eye tissues.After systemic administration,especially long-term administration,the drugs may permeate blood-ocular barrier and cause toxic effects on anterior segment and posterior segment of the eye.In this article,we reviewed the reports and studies of the most commonly recognized drug-induced ocular disorders caused by different topical and systemic administration.Ophthalmologists should pay more attention to the ocular toxicity induced by both topical and systemic administration,improve the capability to distinguish drug-induced symptoms and disease itself,which helps to accurately distinguish and effetely prevent drug-induced ocular toxicity.

Ethambutol optic neuropathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Ethambutol(EMB)has been used as first-line antibiotics to treat tuberculosis. Side effects of ethambutol have been well documented since its original use, with the most serious one being optic neuropathy. EMB-induced optic neuropathy(EON)may be reversible in the early stages, but delayed diagnosis has been shown to result in permanent visual loss. Thus the reversibility of EON is dependent on early detection. In this review, we discuss risk factors, detection methods, treatment and prevention of EON.

Pay more attention to drug-induced ocular toxicity / 中华实验眼科杂志

Medication safety is one of the primary considerations in drug therapy. With the increase of drug categories and the diversification of drug delivery routes, more and more attention has been paid to ocular adverse events caused by topical and systemic administration. Topical administration can directly induce toxicity to eye tissues. After systemic administration,especially long.term administration,the drugs may permeate blood.ocular barrier and cause toxic effects on anterior segment and posterior segment of the eye. In this article,we reviewed the reports and studies of the most commonly recognized drug.induced ocular disorders caused by different topical and systemic administration. Ophthalmologists should pay more attention to the ocular toxicity induced by both topical and systemic administration, improve the capability to distinguish drug.induced symptoms and disease itself, which helps to accurately distinguish and effetely prevent drug.induced ocular toxicity.

A meta-analysis of eye toxicity induced by tamoxifen in breast cancer patients / 中国生化药物杂志

Objective Methodsof meta-analysis was used to investigate the clinical characteristics, related factors of ocular diseases caused by Tamoxifen.MethodsThe literature and key words in the literature search strategy were used to search the literatures related to the toxicity of tamoxifen in the treatment of breast cancer from 1980 to 2016.Refer to the literature, and extract the data information, use revman 5.1.7 statistical analysis.Results Tamoxifen was taken after t unilateral breast cancer resection by the patient,a sharp decline in visual acuity was found at the third month of taking Tamoxifen, and then the hospital diagnosed it was neuropapillitis.The analysis results show that the ocular toxicity of Tamoxifen was generally appeared after taking 1month to 100months.The most common eye diseases that result in Tamoxifen were macular edema and macular crystallization, although the cure rate was high, but if not treated ocular disease in time, blindness rate was high too.Ocular toxicity may be positive correlated with the cumulative dose of Tamoxifen and Tamoxifen concentration.The incidence rate may also positive correlated with age.Adverse reactions may be related to the metabolic rate, eye disease history and so on.Conclusion The clinical treatment of breast cancer treated with Tamoxifen, should pay attention to the ocular toxicity, replace drugs timely when there is any ADR that could not be tolerate.

A Case of Oxaliplatin-Related Ocular Toxicity

PURPOSE: To report a case of oxaliplatin (Eloxatin(R))-related ocular toxicity in a patient with advanced stomach cancer. CASE SUMMARY: A 43-year-old female with advanced stomach cancer experienced visual symptoms during the treatment with oxaliplatin on a XELOX schedule (a combination of oxaliplatin and capecitabine). After 1 cycle of chemotherapy, she complained of blurred vision and visual field defects in both eyes. Visual field tests showed a bilateral concentric field defect and the electroretinogram revealed a marked reduction of responses in both eyes. On the second cycle of chemotherapy, oxaliplatin was discontinued due to suspicious ocular toxicity. Her visual symptoms improved and visual field test showed normal results 1 month after oxaliplatin discontinuation. However, 3 months after oxaliplatin discontinuation, electroretinogram remained abnormal despite the progressive improvement. CONCLUSIONS: Platinum-based antineoplastic agents such as oxaliplatin should be administered with caution because oxaliplatin can cause damage to the retinal photoreceptors and the optic nerve. Early detection of ocular toxicity and discontinuation of oxaliplatin therapy could prevent severe and irreversible visual loss.

Efectos adversos oculares de fármacos sistémicos / Ocular adverse effects of systemic drugs

El 4.3% de las reacciones adversas a medicamentos de uso sistémico se presentan como trastornos oculares. Aunque el síndrome del ojo seco es el efecto adverso más común y probablemente el más benigno, los fármacos de uso sistémico pueden provocar trastornos oculares graves e irreversibles. Este artículo presenta una revisión de los fármacos más relevantes capaces de producir trastornos oculares...

4.3% of all adverse reactions to drugs are ocular disorders. Although the dry-eye syndrome is the most comun and probably the most benign, systemic use drugs can produce serious and irreversible eye disorders. This article presents an overview of the most relevant drugs that can cause disorders in the eye...

Desferrioxamine-related ocular toxicity: A case report.

A 29-year-old lady receiving repeated blood transfusions for β thalassemia since childhood, presented with rapidly deteriorating symptoms of night blindness and peripheral visual field loss. She was recently commenced on high-dose intravenous desferrioxamine for reducing the systemic iron overload. Clinical and investigative findings were consistent with desferrioxamine-related pigmentary retinopathy and optic neuropathy. Recovery was partial following cessation of desferrioxamine. This report highlights the ocular side-effects of desferrioxamine mesylate and the need to be vigilant in patients on high doses of desferrioxamine.

Visual Function Test for Early Detection of Ethambutol-Induced Ocular Toxicity

PURPOSE: The purpose of the present study was to investigate various visual function tests for early detection of ethambutol-induced ocular toxicity. METHODS: A prospective study of 20 eyes of 10 patients being treated with ethambutol was conducted. Visual acuity, visual field, color vision, fundus examination, contrast sensitivity, optical coherence tomography (OCT), and pattern-visual evoked potential (VEP) were assessed. Examinations were performed prior to therapy and every month for 5 months after treatment. VEP was performed every other month. The mean values of each parameter at each month were compared with the baseline examination and a p-value of <0.05 was considered significant. In addition, a greater than 2 standard deviation (SD) change in each parameter from the mean values at baseline was considered as an ocular toxicity induced change in each individual eye. RESULTS: On OCT, a significant increase of the average retinal nerve fiber layer thickness was detected after 4 months of therapy. VEP showed an increased mean latency of the P100 wave after 2 and 4 months of therapy. However, a greater than 2 SD change from the mean values of the baseline was not observed on OCT, while 30% (6/20) of the eyes showed more than a 2 SD increase in VEP latency. Visual acuity, color vision, fundus, contrast sensitivity, and visual field were not affected in any patients. CONCLUSIONS: The authors of the present study consider VEP as a sensitive test to detect early toxicity of ethambutol. VEP can be helpful in identifying subclinical ocular toxicity, especially in the high-risk patients.

Ocular Toxicity of Miconazole in Vitreous Replacement Fluid

To determine the ocular toxicity of intravitreal miconazole, we conducted a controlled trial in 20 pigmented rabbit eyes(10 rabbits). An anterior chamber paracentesis was performed on all animals and 0.4 ml of perfluoropropane(C3F8) gas was injected intravitreally. On day three, when it was fully expanded, eyes were underwent C3F8/fluid exchange with vitreous replacement fluid. The infusion solution contained various amounts of miconazole, 0.5 microgram/ml. 1 microgram/ml, 5 microgram/ml, 10 microgram/ml, 50 microgram/ml, 100 microgram/ml and normal saline for control. Intravitreal infusion was performed for 25-30 minuteds and a total of 100-120 ml of fluid was replaced. Histopathological examination revealed retinal toxic reactions in concentrations of 10 microgram/ml or greater. This study suggests that infusion solution of 5 microgram/ml or less is the concentration exceeds the minimal inhibitory concentration for most of fungi and may be safetly used in the treatment of fungal endaphthalmitis.

Ocular Toxicity of Intravitreal Injection of Miconazole

Miconazole is a synthetic imidazole with a broad spectrum of activity, low systemic and ocular toxicity. To determine the ocular toxicity of intravitreal injection of miconazole, we injected the drugs into the vitreous bodies of 44 rabbit eyes, doses varying from 5 microgram to 500 microgram dissolved in O.1ml of normal saline. Cataract, vitreous opacity, and retinal edema were observed in concentration of 100 microgram or greater, ophthalmoscopically. Histopathological examination revealed retinal toxicity in concentration of 50 microgram or greater. Retina showed hypertrophy of retinal pigment epithelium, clumping of pigments, and disorganization and loss of photoreceptor outer segment. In more advanced changes, subretinal deposits of macrophage and cellular debris, migration of photoreceptor nuclei into the subretinal space, and necrotic changes in all layers were observed.