Visual loss following secondary retinitis pigmentosa (RP) is a rare complication of cytotoxic chemotherapy. Few cases of docetaxel- and/or platinum-induced retinal toxicity have been reported. Routine ocular examination of patients undergoing chemotherapy is required for early recognition and intervention of ocular toxicity. A 72- year-old female undergoing docetaxel and carboplatin combination chemotherapy for the past 3 months presented with complaints of defective vision in both eyes for 2 months. Fundus examination revealed a waxy pale disc in both eyes, arteriolar attenuation, and peripheral bony spicules, suggesting secondary retinitis pigmentosa. Optical Coherence Tomography (OCT) of the macula revealed macular dystrophy. The Humphrey Visual Field (HVF) showed field defects. Despite the reduction in chemotherapy dosage, no improvement was observed during the threeweek follow-up period.
Tamoxifen, an oral medication that blocks estrogen activity, is frequently prescribed for the treatment of advanced breast cancer and as an additional therapy following surgical removal of early stage disease. A 45-year-old female with a history of breast carcinoma treated with tamoxifen presented with sudden onset bilateral visual impairment for 4 days. On ocular examination, the patient exhibited optic disc edema with hyperemia and bilateral anterior pathway defects in visual evoked potentials. Magnetic resonance imaging revealed a thickened right optic nerve sheath with patchy enhancement of the left optic nerve sheath. The patient was diagnosed with bilateral optic neuritis and treated with intravenous methylprednisolone, which resulted in significant improvement in visual acuity and resolution of optic disc edema. This case underscores the importance of vigilant ophthalmological monitoring in patients undergoing tamoxifen therapy to facilitate the early detection and management of ocular complications.