Conjunctival sparing femtosecond laser‐assisted conjunctival autografts for double‐headed pterygium surgery (original) (raw)

Clinical & Experimental Ophthalmology

Abstract

cyclophosphamide-induced ischaemic retinopathy. We are not sure whether bilateral severe retinal ischaemia in our case was induced by either paclitaxel or cyclophosphamide alone or by the synergistic effect of these two drugs. However, this case highlights the fact that ischaemic retinopathy is possible with chemotherapeutic drugs other than platinum analogue. In the absence of fluorescein angiography, we cannot ascertain the exact aetiological diagnosis of this retinal ischaemia; however, the clinical pictures including arteriolar sclerosis, mild venous dilatation, optic disc oedema and gross macular oedema were suggestive of combined occlusion of the central retinal artery and central retinal vein. Retinal vascular dysregulation induced by intravenous paclitaxel administration may account for this manifestation. Although complete loss of vision with no perception of light is usually not seen in these vascular or ischaemic complications, the presenting visual acuity in central retinal arterial occlusion can range from near normal to counting fingers or worse. Accordingly, the clinical picture may also show a wide range from milder ischaemic changes to severe, as seen in our case. In a study examining the natural history of central retinal artery occlusion, Hayreh and Zimmerman found that about 7% of patients (19/260 eyes) presented with no light perception. Another contributing factor for the complete loss of vision could be associated optic nerve ischaemia induced by paclitaxel as reported in previous studies.

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