Ye Ya-ting1,2,#, Zhou Zi-yi1,#, Wen Li-shi, Sun yu2, Chu Zhao-jie2,3,*, Dou Guo-rui1,*
1 Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi′an 710032, China
2 Department of Chinese Materia Medica, College of Life Sciences, Northwestern University, Xi′an 710069, China
3 Department of Ophthalmology, the First Affiliated Hospital of Northwest University (Xi′an First Hospital), Xi′an 710002, China
* CorrespondenceGuo-Rui Dou
Tel: 029-84771273 Email: fierywang@126.com
Zhao-Jie Chu
Tel: 18629620056 Email: chuzhaojie2009@163.com
# Equally contributed to this manuscript
【Abstract】 The adverse ocular reactions to paclitaxels involve a series of damage, which can be observed on ocular surface, ocular appendages and intraocular tissues. They can appear as various clinical symptoms including dry eye, lacrimal duct obstruction, conjunctivitis, keratitis, macular edema, retinal injury, optic nerve injury, and etc. All these symptoms may lead to irreversible visual loss. The mechanisms of these side effects are still unclear. Macular edema, one of the side effects, may be related to the dysfunction of retinal pigment epithelial (RPE) cells and Müller cells which is caused by paclitaxel, while other symptoms may be caused by the cytotoxicity of paclitaxels. In this review, we describe the widely accepted drug-induced ocular disorders and the possible mechanisms, so as to provide some suggestions for the monitoring and management of ocular toxicity.
【Key words】 Paclitaxel, Eye diseases, Drug related side effects and adverse reactions
As the first natural phytochemical drug approved by Food and Drug Administration (FDA), Paclitaxel (Taxol) is an anti-tumor drug with highly efficacy and low toxicity. As taxane widely served as an anti-tumor drug, the number of reports on its adverse side effects is climbing rapidly, mainly including bone marrow suppression, allergic reaction, digestive system reaction, numbness of the hand and foot, liver injury, and etc. However, in recent years, there have been reports of adverse ocular reactions caused by taxane drugs. Such as vision loss [1], dry eye [2], lacrimal duct obstruction [3], conjunctivitis [4], glaucoma [5], optic neuropathy [6], macular edema [7, 8], blindness caused by combination with cisplatin [9], and so on. These adverse side effects have numerous effects on patients’ life quality and their compliance to the therapy. In order to have a comprehensive understanding of the ocular adverse sides caused by taxane drugs as well as and their possible mechanisms in side effects and to improve the safety of the administration, we briefly reviewed the relevant literatures at home and abroad.