Ocular Side Effects are Associated with Anticancer Drugs in Neuro-Ophthalmology

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  • 抗がん剤と神経眼科

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Currently, cancer affects one in every two people. Therefore, development in anticancer drugs has recently been remarkable, and reports of ocular side effects have increased. These side effects are associated with divergence, and, neuro-ophthalmologically, with reduction in visual acuity, visual field loss, diplopia, and photophobia. Damage sites are the optic nerve, retina, extraocular muscles, and cranial nerves. The representative causative agents include cytotoxic drugs（paclitaxel, docetaxel, cisplatin, 5-fluorouracil, etc.）, hormone drugs（tamoxifen）, molecular target drugs（crizotinib, imatinib, etc.）, and immune checkpoint inhibitors（nivolumab, pembrolizumab, ipilimumab, etc.）. Uveitis is a common side effect of immune checkpoint inhibitors, while optic neuropathy and myasthenia gravis are occasional side effects. Ocular myasthenia gravis tends to suddenly shift to the systemic type; therefore, the clinical course should be observed. Balance between side effects（risk）and therapeutic effects（benefit）is important in cancer therapy, and early detection of side effects and medical cooperation are required.

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