ABSTRACT
Background Carboplatin and paclitaxel are two standard chemotherapeutic agents known to cause neurotoxicity. In this study, we aim to evaluate the toxicity of these agents by measuring the peripapillary retinal nerve fiber layer (RNFL) and macular thickness in patients with endometrial and ovarian cancers who are receiving them. Methods A one-year prospective cohort study involving 28 patients who were treated intravenously with carboplatin (200-400 mg/m2) and paclitaxel (175 mg/m2) three-weekly for six cycles was conducted. RNFL and macula thickness were measured using optical coherence tomography (OCT) before the commencement of chemotherapy, after the third cycle, and one month after the sixth cycle. The main outcome measurements were the average RNFL thickness and central subfield thickness of the macula. Results The mean age of the 28 participants was 54.68 years old (standard deviation [SD] 9.03). Eleven had endometrial cancer, while 17 had ovarian cancer. The mean of the average RNFL thickness during baseline pre-chemotherapy was 96.43 µm (SD 11.39). One month after cessation of treatment, the mean RNFL thickness increased to 101.57 µm (SD 13.54). Statistical analysis showed a significant increment in the mean RNFL thickness (p ≤ 0.001), from baseline to after three cycles, and baseline to one month after six cycles of chemotherapy, except the nasal quadrant. The increment of all macular quadrants was statistically significant (p < 0.05) except for central subfield thickness. Conclusion Systemic administration of carboplatin and paclitaxel affected both the peripapillary RNFL and macula thickness. This represents early evidence of subacute subclinical retinal toxicity. OCT can be used as a screening tool to assess peri-chemotherapeutic retinal alterations.
ABSTRACT
The purpose of this study was to examine the relationship between the mood, physical activity, coping, and mental health of Malaysians during the COVID-19 pandemic. A cross-sectional study was conducted via an online survey, with self-administered questionnaires. The respondents were recruited using snowball sampling techniques. The Brunel Mood Scale (BRUMS), the Exercise Regulations in Exercise-3 (BREQ-3), the Brief Coping Orientation of Problem Experienced (Brief COPE), and the Depression, Anxiety, and Stress Scale (DASS-21) were used. A path analysis was conducted on the data. A total of 842 people participated in the survey. The mean age of participants was 22 years (interquartile range = 6) and 24.0% were male. The final path model fitted the data well, with a comparative fit index of 0.998, a Tucker-Lewis index of 0.988, a standardized root mean square residual of 0.001, and a root mean square error of approximation of 0.072. In this study, there were significant path relationships between mood, exercise behavior, coping, and mental health. Additionally, it was demonstrated that the variables of mood, exercise behavior, and coping have both direct and indirect effects on mental health. The results also suggested that utilizing appropriate coping skills, exercise behavior, and positive mood can directly lower levels of depression, anxiety and stress, and that appropriate coping skills and positive mood can directly affect exercise behavior.
