Progressive Bilateral Visual Loss Due To Vincristine Induced Optic Neuropathy

Abstract

Optic neuritis (ON) is an inflammation of the optic nerve that usually stems from demyelinating disorders such as multiple sclerosis (MS). It leads to subacute unilateral or bilateral vision loss accompanied with pain on eye movements. Certain drugs cause optic neuropathy due to toxicity to ganglion cells. Thorough history, clinical diagnosis with high degree of suspicion and immediate treatment with high-dose corticosteroids is

the usual regimen followed for regain of visual acuity. Vincristine is a plant derived mitotic inhibitor used in the treatment of several cancers. While vincristine is generally well-tolerated, neurotoxicity is a known adverse effect, most commonly presenting as peripheral neuropathy. Optic neuropathy, especially bilateral, is exceedingly rare and poses a risk of irreversible blindness if not promptly identified. There are many reports of unilateral vincristine induced neuropathy in paediatric tumours or haematological cancers. This

report discusses a patient with right fronto-temporal Glioblastoma Multiforme who developed bilateral optic neuropathy secondary to vincristine therapy.