Severe ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy

PURPOSE: To report severe ocular and orbital toxicity after administration of intracarotid etoposide phosphate and carboplatin. METHOD: Case report. RESULTS: A 52-year old man with glioblastoma multiforme underwent left intr acarotid administration of etoposide phosphate and carboplatin inferior to the ophthalmic artery. Within 7 hours, a nonpupillary block angle-closure g laucoma developed secondary to uveal effusion in the ipsilateral eye, which was relieved by cycloplegia, Four days later, severe orbital inflammation resulted in a visual acuity of counting fingers, proptosis, optic neuropath y, and total external ophthalmoplegia in the eye. The patient's condition i mproved after a lateral cantholysis and administration of high-dose intrave nous corticosteroids, Two weeks later, an anterior uveitis occurred in the left eye, which responded to topical corticosteroids, During a a-month peri od, the patient recovered to a visual acuity of 20/70, near normal motility , and normal intraocular pressure, and the ocular and orbital inflammation resolved. Preexisting ipsilateral chemotherapy-induced maculopathy became m ore pronounced. CONCLUSION: Ocular and orbital toxicity after intracarotid etoposide phosph ate and carboplatin therapy is infrequently reported. (Am J Ophthalmol 1999 ;127: 230-233, (C) 1999 by Elsevier Science Inc. All rights reserved.).