Clinical Features and Prognosis of Paclitaxel-related Cystoid Macular Edema: A Case Series

Purpose: To describe the clinical characteristics and course of paclitaxel (PTX)-related cystoid macular edema (CME) Methods: Electronic medical records were retrospectively reviewed for seven patients diagnosed with PTX-related CME at a single center in Seoul, South Korea, between January 2011 and April 2025.Collected data included demographics, chemotherapy regimen details, and ophthalmologic findings such as best-corrected visual acuity (BCVA), fundus photography, optical coherence tomography, and, when available, fundus fluorescein angiography.Management strategies and treatment outcomes, including changes in BCVA and central macular thickness (CMT), were analyzed.Results: Seven patients were diagnosed with PTX-related CME, all with bilateral involvement.The mean interval from initiation of PTXbased chemotherapy to CME diagnosis was 42.7 weeks (median, 34.9 weeks; range, 24.1-78.7 weeks).Median BCVA improved from 0.40 LogMAR (IQR, 0.22-0.47)at baseline to 0.10 LogMAR (IQR, 0.00-0.24)at the final visit (p = 0.008), and the median CMT decreased from 617.0 m (IQR, 345.25-696.50m) at baseline to 255.0 m (IQR, 235.75-300.25 m) at the final visit (p = 0.001).Among six patients who discontinued PTX, initial CME improvement was observed at a mean of 4.5 weeks (median, 4.1 weeks; range, 1.1-11.1 weeks) following cessation, and complete resolution was confirmed in five patients, at a mean of 12.8 weeks (median, 11.1 weeks; range, 9.0-17.1 weeks).One patient who was unable to discontinue PTX achieved delayed CME resolution and visual recovery 28 weeks after dose reduction and interval extension.Conclusions: Favorable anatomical and visual outcomes of PTX-related CME were achieved following drug cessation.In cases where discontinuation was not feasible, gradual improvement in CME occurred after dose reduction and interval extension.Awareness of this potential ocular adverse event is important for both ophthalmologists and oncologists managing patients on PTX-based chemotherapy.