Bilateral Optic Neuropathy Secondary to Intravenous Carboplatin Therapy

To report a case of carboplatin-induced bilateral optic neuropathy in a patient with metastatic squamous cell carcinoma of the tongue.

Case Report: 

A 65-year-old man with a history of squamous cell carcinoma of the tongue with metastasis to the right axillary lymph node treated with carboplatin and paclitaxel was evaluated for decreased visual acuity in both eyes. Visual acuity was 20/70 in the right eye and no light perception in the left eye. On dilated fundus examination, optic disc edema was present in both eyes with more severity in the left eye, flame shape hemorrhages around the optic nerve head in both eyes and cotton wool spots around the left optic nerve head. Brain and orbital MRI demonstrated enhancement of the bilateral optic nerve sheaths. He was diagnosed with bilateral carboplatin-induced optic neuropathy.

Our findings in this case justify monitoring of patients during their course of intravenous carboplatin therapy.