Targeted Cancer Therapy and Its Ophthalmic Side Effects: A Review.

Targeted cancer therapy agents are the latest development in cancer therapeutics. Although the spectrum of their use continues to expand, ocular side effects are frequently encountered with the use of cancer therapeutics. This review describes the ocular side effects of targeted cancer therapy agents.

Orbital Compartment Syndrome After High-speed Air-Gasoline Blast Injury.

Orbital compartment syndrome is an ophthalmologic emergency that requires timely surgical intervention. The authors present a rare case of orbital compartment syndrome in a 30-year-old male injured by forceful entry of air-gasoline mixture into the orbit, secondary to inadvertent firing of the piston from running mechanical diagnostics on an automobile internal combustion engine. Orbital CT revealed extensive orbital emphysema with both pre- and postseptal involvement and diffuse chemical cellulitis. Serial exams revealed rapid deterioration of vision with elevated intraocular pressure and development of eyelid, corneal, and orbital edema; a relative afferent pupillary defect and optic nerve hypoperfusion. He was started on intravenous steroids and underwent an emergent lateral canthotomy with cantholysis, which temporarily reduced the intraocular pressure. However, a second rapid increase in soft tissue swelling resulted in another episode of ocular hypertension and compressive optic neuropathy, requiring emergent orbital bony decompression, which was followed by decreased intraocular and orbital pressure. The patient later developed progressive corneal opacification indicating delayed chemical injury. This was managed with a 10-day course of aggressive topical and systemic antiinflammatory agents with significant improvement in visual acuity. At last follow up, the vision was 20/30 and the corneal and eyelid edema had cleared.

Significant visual improvement with vision rehabilitation delayed three decades from disease onset.

PURPOSE: This is a report of an adult patient showing improvement in visual function from rehabilitation for longstanding homonymous hemianopsia. We present his medical history and visual function testing pre- and post-therapy, demonstrating an improvement in both subjective and objective measures. OBSERVATIONS: A 40-year-old male with history of a ruptured arteriovenous malformation at age 10 years, treated with embolization therapy, was referred to the neuro-ophthalmology clinic for evaluation of right homonymous hemianopsia noted on Humphrey visual field (HVF) testing. At the most recent neuro-ophthalmology exam, the HVF showed a right homonymous hemianopsia with a mean deviation of -11.92 decibels (dB) in the right eye (OD) and -17.97 dB in the left eye (OS). He was referred to visual rehabilitation and showed marked improvement in visual functioning after a standard course of therapy. CONCLUSIONS AND IMPORTANCE: The efficacy of visual therapy is demonstrated in the literature. Notably lacking from the literature is a consideration of whether vision rehabilitation is similarly effective in patients that present distantly from the original insult. This case presents the potential for efficacy of visual rehabilitation even decades after the original insult.