Visual System Toxicity Associated with Intra-arterial Chemotherapy

Many chemotherapeutic agents are associated with visual system toxicity with high dose intravenous and intra-arterial administration. Intra-arterial injection of nitrosureas is often associated with a vasculopathy of the carotid(!), ophthalmic(2), and retinal and choroidal arteries(3) with emboli, occlusions or both. A delayed loss of vision results from ischaemia to the eye and results in an ischemic oculopathy syndrome~ 2 - 3 ) Retinal infarcts and hemorrhages, ischaemic papillopathy, and neovascular glaucoma are found in these patients. Progressive visual loss to blindness can result.