Central Retinal Artery Occlusion during Cisplatin and Etoposide Chemotherapy for Small Cell Lung Cancer

We present our findings in a case of central retinal artery occlusion (CRAO) that developed in a patient while being treated with intravenous cisplatin (CDDP) and etoposide (VP16) for small cell lung cancer. The patient was a 67-year-old woman who had lung lobectomy for small cell lung cancer. She began adjuvant chemotherapy with CDDP and VP16 after the surgery, and after 13 days of chemotherapy, she developed a sudden painless decrease of vision in her left eye. She was referred to Department of Ophthalmology, and our examination found that her decimal visual acuities were 1.0 OD and light perception OS. Fluorescein angiography showed a CRAO in her left eye. Two months later, she had a sharp pain in the left eye because of neovascular glaucoma, and cyclophotocoagulation was immediately performed. Although her visual function did not recover completely (light perception OS), the pain was alleviated after the cyclophotocoagulation. Physical examinations showed no additional abnormalities of the cardiovascular system. Although a CRAO during chemotherapy is extremely rare, ophthalmologists and internists should remember that a CRAO can develop in patients undergoing combined chemotherapy even though other cardiovascular events may not be present.