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.