Blinding Optic Neuropathy Associated With Carboplatin Therapy: A Case Report and Literature Review.

Various forms of cancer and chemotherapeutics are associated with optic neuropathy. Cisplatin is a platinum analogue chemotherapeutic commonly associated with ocular toxicity among many other serious adverse effects. Carboplatin is a more chemically stable platinum analogue that is generally better tolerated with a comparatively favorable side effect profile. There are very few reports of carboplatin precipitating optic neuropathy. This case report describes a rare occurrence of carboplatin-induced blinding optic neuropathy. We treated a patient receiving carboplatin for neuroendocrine bladder cancer who developed rapidly progressive bilateral optic neuropathy over the course of three days. Upon evaluation at our clinic, his visual acuity had declined to light perception only and 20/60 in his left and right eye, respectively. Carboplatin therapy was immediately held and steroids were initiated. Despite the intervention, the patient's visual deficits have not improved at the one-year follow-up. Although the mechanism by which carboplatin causes ocular toxicity remains speculative, arterial ischemia appears to be the likely mechanism given the irreversible nature of visual decline. As demonstrated by our patient's course, irreversible vision loss despite high-dose steroid intervention necessitates expeditious recognition and management of this rare adverse effect. ​​​​​.

Stepwise Self-Assembly and Dynamic Exchange of Supramolecular Nanocages Based on Terpridine Building Blocks.

Coordination-driven self-assembly as a powerful bottom-up approach has been extensively used to construct multifarious supramolecular architectures with increasing complexity and functionality. Due to the unique cavity structures and precisely controllable dimensions, 3D supramolecules display unprecedented properties and functions in catalysis, sensing, gas storage, and smart materials. Herein, we have built two 3D nanocages with different sizes by changing the length of the organic ligand arms. The structures were characterized by 1D and 2D NMR spectroscopy, electrospray ionization-mass spectrometry (ESI-MS), traveling wave ion mobility-mass spectrometry (TWIM-MS), gradient tandem-mass spectrometry (gMS2 ), and transmission electron microscopy (TEM). Furthermore, the intermolecular dynamic exchange of two 3D nanocages was conducted to construct a series of hybrid 3D structures as evidenced by mass spectrometry.