[e-farmacos] Reaccion adversa a la vincristina (cont.)

["Rousseau, Marcela" <marcerousseau@hotmail.com>]

Estimado Hector,

Te envio la informacion suministrada por el Micromedex acerca de la ceguera
causada por vincristina 

ADVERSE REACTIONS 
3.3.8 OCULAR 
A. EYE EFFECTS 
1. Blindness, diplopia, ptosis, night blindness, and optic atrophy have been
associated with vincristine therapy. 
B. BLINDNESS 
1. SUMMARY: 
a. Permanent loss of vision has been reported with vincristine therapy (Prod
Info Oncovin(R), 1999; Teichmann & Dabbagh, 1988). Complete blindness which
persisted through 6 months of follow- up occurred in an 18-year-old man
following the fifth 10-day cycle of therapy with vincristine 2 milligrams
(mg) intravenous followed by cyclophosphamide 600 mg orally for 5 days with
prednisolone 100 mg orally for 5 days for treatment of lymphocytic leukemia
(Awidi, 1980). 
C. OCULAR FINDINGS 
1. SUMMARY: 
a. Ocular toxicity has resulted from vincristine therapy. DIPLOPIA and other
symptoms from cranial nerve palsies have been reported (Griffin & Garnick,
1981). In a series of 50 patients, PTOSIS and diplopia were reported to
occur at an incidence of 32% following treatment with vincristine. Ocular
muscle complications were also reported along with one case of night
blindness (Sandler et al, 1969). 
D. OPTIC ATROPHY 
1. SUMMARY: 
a. Optic atrophy with blindness have been reported has been reported with
vincristine therapy (Prod Info Oncovin(R), 1999). Bilateral optic atrophy
developed in a 15-year-old girl following posterior craniectomy, whole
neuraxis radiation therapy, and weekly vincristine. Following
discontinuation of therapy, recovery of visual function occurred (Shurin et
al, 1982). 
2. LITERATURE REPORTS: 
a. Bilateral optic atrophy developed in a 15-year-old girl following
posterior craniectomy, whole neuraxis radiation therapy (total dose 5,200
rads), and weekly vincristine. Following the third dose of vincristine (2
milligrams (mg) intravenously) the patient developed confusion and
hallucinations, which cleared within 5 days. Following the tenth weekly dose
of vincristine, which was reduced to 1 mg due to lower extremity weakness
and difficulty with fine motor coordination, the girl complained of
decreased visual acuity in the left eye, pain in the eyes, diplopia, and
BLURRED VISION. Marked pallor of both optic nerve heads was present. There
was peripheral construction of the visual fields and central scotomata.
Visual acuity was 20/80 OD and 20/400 OS despite 20/02 OC prior to therapy.
Following discontinuation of therapy, recovery of visual function occurred
along with improvement in visual function and other signs of neurotoxicity
(Shurin et al, 1982). 

Marcela Rousseau
Hospital Nacional de Pediatria Juan P. Garrahan
Farmacovigilancia
(Argentina)