2 Occurrence of adverse ocular side effects
The adverse ocular sides effects of taxane drugs involve ocular appendage and various intraocular tissue structures, with various clinical manifestations but no specificity. Eye diseases caused by taxane mainly include dry eye, conjunctivitis, glaucoma, retinopathy and optic neuropathy. According to the Drug Instructions, the injectable paclitaxel (albumin-bound) specification states that eye/visual adverse events occurred in 13% population (48/366) of clinical studies in the United States and Europe, while severe cases occurring in 1% population. The main symptoms were keratitis and blurred vision which were usually reversible. In a phase Ⅰ clinical study of Chinese patients, 1 out of 104 patients developed transient blurred vision and diplopia. In a randomly controlled clinical study of Chinese patients with metastatic breast cancer, 4 out of 100 patients developed mild blurred vision, which was transient and self-healing. Noguchi [14] has conducted a retrospective study of risk factors concerning ocular disorders caused by paclitaxel and NAB-paclitaxel. This retrospective study targeted patients who were newly treated with paclitaxel or NAB-paclitaxel at Kyoto Okamoto Memorial Hospital between April 1, 2012, and March 31, 2017. Of 128 subjects, 13 (10.2%) had ocular disorders with symptom ranging from grades 1 and 2. The symptoms included conjunctivitis or subconjunctival hemorrhage (3.1%), visual acuity reduction (2.3%), blurred vision and eye pain (1.6% each), eye mucus, blepharitis, stye, watering eyes, photopsia, and muscae volitantes (0.8% each). Alvarez⁃Fernandez et al. [15] shared a 73-year-old patient with metastatic breast cancer who developed macular edema after being treated with paclitaxel, which disappeared after drug withdrawal. In this paper, 57 cases of paclitaxel-related macular edema reported in 52 literatures were analyzed. The median time of occurrence of macular edema after taking the drug among these patients was 4.25 months. Among these patients, 92.86% were diagnosed as macular edema and bilateral vision loss in the initial examination, and most of their symptoms reversed after paclitaxel withdrawal.