Abstract
Purpose :
Chemotherapy-induced peripheral neuropathy (CIPN) is a common debilitating condition that occurs in patients treated for cancer. This observational cross-sectional study aimed to investigate the relationship between ocular surface discomfort and peripheral neuropathic dysfunction in patients who have undergone treatment with the neurotoxic drug paclitaxel.
Methods :
Cancer patients who had completed paclitaxel treatment between 3 to 24 months prior to assessment (n=20) and age- and sex-matched healthy control subjects (n=20) were recruited. Participants were assessed with the Ocular Surface Disease Index (OSDI) to measure ocular discomfort relating to 3 subcategories covering symptoms, visual function and environmental triggers. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-CIPN20) was used to probe neuropathic dysfunction. The reduced Total Neuropathy Scale (TNSr) was implemented as a clinical and objective measure of CIPN. Mann-Whitney U test was used for statistical analysis. A p-value <0.05 was considered statistically significant.
Results :
The treatment and control groups were not significantly different in age (Mean ± standard deviation; 48.9 ± 15.3 and 50.4 ± 13.0 years, p=0.93) and body mass index (24.9 ± 5.1 and 27.0 ± 4.6, p=0.12). QLQ-CIPN20 and TNSr scores were significantly higher in the paclitaxel group, which indicated worse neuropathy, compared to the control group (p<0.001 and p=0.01, respectively). Only the OSDI symptom subcategory was significantly worse in the paclitaxel group compared to healthy controls (p=0.04). Within the paclitaxel group, the more severe symptomatic and clinical neuropathy scores as assessed with QLQ-CIPN20 and TNSr were significantly strongly correlated (p<0.001) with worse OSDI total scores (r=0.81 and r=0.82, respectively), and the symptom (r=0.84 and r=0.88, respectively) and visual function (r=0.78) subcategories.
Conclusions :
Patients who have undergone paclitaxel treatment with more severe neuropathic signs and symptoms also have more severe ocular discomfort, suggesting that ocular surface and peripheral nerve structures could be adversely affected with neurotoxicity. Future research investigating clinical ocular surface measures and corneal nerve microstructural changes will aid our understanding of the impact of neurotoxic chemotherapy on the ocular surface.
This is a 2020 ARVO Annual Meeting abstract.