This article is more than 5 years old. Information may no longer be current.
Vision loss in cancer patients deserves special consideration
Click Here to Manage Email Alerts
CHICAGO — General ophthalmologists and neuro-ophthalmologists alike must be aware that a history of cancer is an important factor in diagnosing vision loss in their patients, said Nicholas J. Volpe, MD. In patients with such a history, complications of cancer must be considered in the differential diagnosis to ensure proper management, he said.
Speaking during the Neuro-ophthalmology Subspecialty Day preceding the American Academy of Ophthalmology meeting, Dr. Volpe said that the direct effects of cancer can affect the visual pathway at many points, and the remote effects through paraneoplastic processes can also alter both retinal and optic nerve function.
Vision loss can also be associated with treatment complications from radiation or chemotherapeutic agents, he said.
“Obtaining a careful history from the patient is always critical,” Dr. Volpe said, noting that any family history of cancer should be ascertained, as well as a history of metastatic disease.
Isolated metastases to the optic nerve are extremely rare, he said; the most common metastatic tumors to the optic nerve are adenocarcinomas.
Patients with lymphoma or leukemia can present with direct infiltration of the optic nerve head and mass lesions in the orbit, according to Dr. Volpe. Radiation is the mainstay of treatment of lymphoma and leukemia patients who have progressive vision loss, he said.