We report the case of a 44-year-old woman with
breast cancer who experienced visual loss and altered color vision after two cycles of
chemotherapy with
5 fluorouracil,
epirubicin, and
cyclophosphamide. She was referred to our Ophthalmology department with suspicion of
toxic optic neuropathy. Clinical examination revealed altered color perception in the right side along with a
central scotoma on visual field testing. Electrophysiological tests including visual evoked potentials were normal. Funduscopic examination was compatible with bilateral serous
retinal detachment. Optical coherence tomography (OCT) demonstrated serous detachment of the retina bilaterally associated with small detachments of the pigment epithelium. Additionally,
fluorescein angiography (FA) revealed multiple sites of
fluorescein leakage. After 2 months, the clinical findings remained unchanged. An oncological consultation revealed that the patient had received two cycles of intravenous
dexamethasone (4 mg) for 3 days in order to treat
chemotherapy-induced
nausea and
vomiting. A diagnosis of
steroid-induced
central serous chorioretinopathy was then made. At the last follow-up visit, the patient's visual acuity, color vision, OCT, and FA were back to normal. To our knowledge, this is the first reported case of bilateral severe visual loss secondary to
corticosteroid-induced
central serous chorioretinopathy in a patient on
breast cancer therapy. With the increase use of
anti-emetic drugs in
cancer chemotherapy, we have to be aware of this possible visual complication.