First Author: M.Moutsou UK
Co Author(s):
Purpose:
To present the history, documented signs and management of a case of significant subcapsular cataract formation in a 47-year old, menstruating woman, after a 2-month treatment with a subcutaneous slow-release implant of a Gonadorelin-analogue (Zoladex; contains the active ingredient of Goserelin Acetate)
Setting:
: The case was assessed and diagnosed in our clinic and had later treatment of Phacoemulsification and Intra-ocular Lens Implantation in the mostly affected Right Eye. She was subsequently followed up for the evaluation of the less affected Left Eye.
Methods:
The history, visual acuities, signs and management of this unusual case will be presented. Detailed description and photos of the cataracts will be shown. Both eyes were evaluated after the removal of the subcutaneous hormone-releasing device and followed up to assess progression, outcome of surgery and and further visual performance.
Results:
The rapid formation of a significant cataract in a relatively young woman after the subcutaneous administration of a slow-release Gonadorelin-analogue supports the involvement of this metabolic factor in the pathogenesis of cataract. Although a number of metabolic factors have already been documented in association with cataract formation, this is the second reported case of a Gonadorelin-analogue, administered in slow-release form, to cause cataract in our knowledge and the first one in a woman - the other one being that of a 52-year old man, treated for prostate cancer. Gonadorelin-analogues are currently used for the treatment of both, breast and prostate cancer, as well as endometriosis, uterus fibroids and assisting IVF. Although their assisting use in the treatment of fibroids and IVF is short-term, consisting of 1-3 slow-release, monthly injections, their use in the treatment of other cases can be multiple and long-term. In our case, 2 injections only were sufficient to cause significant cataract in one eye, resulting in poor vision and requiring surgery and one of a lesser degree in the other eye and to cause premature withdrawal from the planned Gonadorelin-analogue treatment.
Conclusions:
Gynaecologists and Ophthalmologists should both be aware of the possibility of metabolic cataract formation in young-aged women when repeat slow-release Gonadorelin-analogue implants are considered as the treatment of choice, in cases such as uterus fibroids, endometriosis and breast cancer.
Financial Disclosure:
None
