Maculopathy associated with combination chemotherapy and osmotic opening of the blood-brain barrier

Robert H. Millay; Michael L. Klein; W. Thomas Shults; Suellen A. Dahlborg; Edward A. Neuwelt

doi:10.1016/0002-9394(86)90536-2

Maculopathy associated with combination chemotherapy and osmotic opening of the blood-brain barrier

Robert H. Millay, Michael L. Klein, W. Thomas Shults, Suellen A. Dahlborg, Edward A. Neuwelt

Research output: Contribution to journal › Article › peer-review

56 Scopus citations

Abstract

Eleven patients with intracranial malignant neoplasms underwent hyperosmotic opening of the blood-brain barrier by rapid mannitol infusion via the internal carotid or vertebral artery. Cyclophosphamide was administered intravenously preceding the mannitol infusion and methotrexate was infused after the mannitol via the same artery. Both the mannitol and methotrexate delivered via the carotid artery have direct access to the ipsilateral choroidal and retinal circulations. In these patients, retinal pigment epithelial changes eventually developed ipsilateral to the carotid infusions. The changes probably represent the toxicity of intraarterial methotrexate possibly potentiated by mannitol-induced opening of the blood-retinal barrier. Functional visual loss was minimal and was not a limiting factor with this therapeutic modality.

Original language	English (US)
Pages (from-to)	626-632
Number of pages	7
Journal	American journal of ophthalmology
Volume	102
Issue number	5
DOIs	https://doi.org/10.1016/0002-9394(86)90536-2
State	Published - Nov 15 1986

ASJC Scopus subject areas

Ophthalmology

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10.1016/0002-9394(86)90536-2

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@article{a973cdf4f3ef483d99dd0be8659c4eac,

title = "Maculopathy associated with combination chemotherapy and osmotic opening of the blood-brain barrier",

abstract = "Eleven patients with intracranial malignant neoplasms underwent hyperosmotic opening of the blood-brain barrier by rapid mannitol infusion via the internal carotid or vertebral artery. Cyclophosphamide was administered intravenously preceding the mannitol infusion and methotrexate was infused after the mannitol via the same artery. Both the mannitol and methotrexate delivered via the carotid artery have direct access to the ipsilateral choroidal and retinal circulations. In these patients, retinal pigment epithelial changes eventually developed ipsilateral to the carotid infusions. The changes probably represent the toxicity of intraarterial methotrexate possibly potentiated by mannitol-induced opening of the blood-retinal barrier. Functional visual loss was minimal and was not a limiting factor with this therapeutic modality.",

author = "Millay, {Robert H.} and Klein, {Michael L.} and {Thomas Shults}, W. and Dahlborg, {Suellen A.} and Neuwelt, {Edward A.}",

note = "Funding Information: From the Department of Ophthalmology (Drs. Millay, Klein, and Shults) and the Division of Neurosurgery (Ms. Dahlborg and Dr. Neuwelt), Oregon Health Sciences University, Portland. This study was supported in part by Research to Prevent Blindness, Inc., the Veterans Administration, and National Institutes of Health grant 31770.",

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doi = "10.1016/0002-9394(86)90536-2",

language = "English (US)",

volume = "102",

pages = "626--632",

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T1 - Maculopathy associated with combination chemotherapy and osmotic opening of the blood-brain barrier

AU - Millay, Robert H.

AU - Klein, Michael L.

AU - Thomas Shults, W.

AU - Dahlborg, Suellen A.

AU - Neuwelt, Edward A.

N1 - Funding Information: From the Department of Ophthalmology (Drs. Millay, Klein, and Shults) and the Division of Neurosurgery (Ms. Dahlborg and Dr. Neuwelt), Oregon Health Sciences University, Portland. This study was supported in part by Research to Prevent Blindness, Inc., the Veterans Administration, and National Institutes of Health grant 31770.

PY - 1986/11/15

Y1 - 1986/11/15

N2 - Eleven patients with intracranial malignant neoplasms underwent hyperosmotic opening of the blood-brain barrier by rapid mannitol infusion via the internal carotid or vertebral artery. Cyclophosphamide was administered intravenously preceding the mannitol infusion and methotrexate was infused after the mannitol via the same artery. Both the mannitol and methotrexate delivered via the carotid artery have direct access to the ipsilateral choroidal and retinal circulations. In these patients, retinal pigment epithelial changes eventually developed ipsilateral to the carotid infusions. The changes probably represent the toxicity of intraarterial methotrexate possibly potentiated by mannitol-induced opening of the blood-retinal barrier. Functional visual loss was minimal and was not a limiting factor with this therapeutic modality.

AB - Eleven patients with intracranial malignant neoplasms underwent hyperosmotic opening of the blood-brain barrier by rapid mannitol infusion via the internal carotid or vertebral artery. Cyclophosphamide was administered intravenously preceding the mannitol infusion and methotrexate was infused after the mannitol via the same artery. Both the mannitol and methotrexate delivered via the carotid artery have direct access to the ipsilateral choroidal and retinal circulations. In these patients, retinal pigment epithelial changes eventually developed ipsilateral to the carotid infusions. The changes probably represent the toxicity of intraarterial methotrexate possibly potentiated by mannitol-induced opening of the blood-retinal barrier. Functional visual loss was minimal and was not a limiting factor with this therapeutic modality.

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JO - American journal of ophthalmology

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IS - 5

ER -

Maculopathy associated with combination chemotherapy and osmotic opening of the blood-brain barrier

Abstract

ASJC Scopus subject areas

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