Perte des cellules ganglionnaires de la retine secondaire a la prise de vincristine. [Loss of ganglion cells in the retina secondary to vincristine therapy]

Details

Serval ID
serval:BIB_7652610D7D72
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Perte des cellules ganglionnaires de la retine secondaire a la prise de vincristine. [Loss of ganglion cells in the retina secondary to vincristine therapy]
Journal
Klinische Monatsblatter fur Augenheilkunde
Author(s)
Munier  F., Uffer  S., Herbort  C. P., Perentes  E., Diamantis  I., Othenin-Girard  P., Grounauer  P. A., Rutz  H. P., Biollaz  J.
ISSN
0023-2165 (Print)
Publication state
Published
Issued date
05/1992
Volume
200
Number
5
Pages
550-4
Notes
Case Reports
English Abstract
Journal Article --- Old month value: May
Abstract
We report the case of a 25-year-old black female from Zaire with AIDS diagnosed 2 years earlier. Nine months before her death, she was treated for a disseminated Kaposi sarcoma with vincristin, adryamycin and bleomycin. At that time, visual acuity was normal and ophthalmologic examination was unremarkable except for the presence of bilateral Drusen and a cotton wool spot OS. Three months after the onset of chemotherapy, the patient complained of progressive visual field constriction, which progressed to blindness within a 4 month period. Five months after the onset of the tri-therapy a bilateral CMV retinitis developed, which was successfully treated by intravitreous injections of ganciclovir. This therapy was stopped as soon as blindness was established, with subsequent massive bilateral recurrence of the CMV retinitis. Histologic examination showed complete atrophy of the retinal ganglion cells and areas of CMV retinitis. The optic nerve was demyelinated and exhibited astrocytic gliosis. Immunohistochemistry confirmed the presence of CMV in infected retina and revealed the absence in the optic nerve of the class III beta-tubulin isotype and of the 200 kd neurofilament subunit. In contrast, oculomotor nerves appeared intact. The presence of HIV in the eye and in the optic nerve was excluded using PCR technique. The retinal ganglion cell loss and optic nerve atrophy appeared to be purely degenerative in nature, since there was no evidence of vascular occlusion, inflammation or retrobulbar compressive process. We therefore conclude that blindness was caused by vincristine therapy. The patient actually received 22 mg of vincristin intravenously in 11 courses over 7 months, although discontinuation was recommended by us after 5 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Keywords
Acquired Immunodeficiency Syndrome/*complications Antineoplastic Combined Chemotherapy Protocols/*therapeutic use Bleomycin/administration & dosage Cytomegalovirus Infections/diagnosis Doxorubicin/administration & dosage Female Humans Retinal Ganglion Cells/*drug effects Retinitis/diagnosis Sarcoma, Kaposi/*drug therapy Skin Neoplasms/*drug therapy Vincristine/administration & dosage/*adverse effects Visual Acuity/drug effects
Pubmed
Web of science
Create date
28/01/2008 13:54
Last modification date
20/08/2019 15:33
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