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NEUROLOGY 1988;38:284
© 1988 American Academy of Neurology

Visual system toxicity following intra-arterial chemotherapy

M. J. Kupersmith, MD, L. P. Frohman, MD, I. S. Choi, MD, S. H. Foo, MD, E. Hiesinger, MD, A. Berenstein, MD, A. Wise, BA, R. E. Carr, MD and J. Ransohoff, MD

From the Departments of Ophthalmology (Drs. Kupersmith, Frohman, and Carr), Neurology (Drs. Kupersmith, Foo, and Hiesinger), Neuroradiology (Drs. Choi and Berenstein), and Neurosurgery (Drs. Berenstein and Ransohoff, and Ms. Wise), New York University Medical School, New York, NY

We studied the effects of intra-arterial chemotherapy on the visual system of 29 consecutive patients with gliomas. As expected, infra-ophthalmic carotid infusion of cisplatin or carmustine (BCNU) was associated with clinically apparent anterior visual pathway lesions. Electroretinography revealed retinal dysfunction in patients without clinical abnormalities. Supra-ophthalmic carotid infusion of cisplatin or BCNU caused no retinal or optic nerve lesions. Electroretinography was abnormal in only one of these patients. Our results indicated that BCNU and cisplatin cause ischemic damage and are toxic to both retinal and neural tissue in patients with gliomas.

Address correspondence and reprint requests to Dr. Kupersmith, Associate Professor of Neurology and Ophthalmology, 530 First Avenue, New York, NY 10016.

Supported by BTCG, NCI grant #CA36014, unrestricted grant from Research to Prevent Blindness, Inc., and Retinitis Pigmentosa Foundation Fighting Blindness.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April 1985.

Received February 6, 1987. Accepted for publication in final form May 21, 1987.




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