his chemotherapeutic regimen consisted of bevacizumab , paclitaxel ( 175 mg / m for 5 months ) , and carboplatin . six cycles of chemotherapy over five months has been performed and followed by monthly intravenous bevacizumab injection for maintenance therapy . on initial examination , findings of fundus examination were within normal limits except for bilateral cystic change of the macula . fluorescein angiograms of the right eye showed weak hyperfluorescence in the parafoveal area in the late frame , demonstrating macular edema . optical coherence tomography ( oct ) imaging revealed bilateral cme with a foveal thickness greater than 500 m ( fig . no central scotoma was found in visual field examination , and b - wave amplitude was diminished in scotopic and mesopic electroretinogram . the cme was thought to be secondary to paclitaxel use , which had been discontinued for one month at that time . intravitreal bevacizumab injection in the right eye and intravitreal bevacizumab plus triamcinolone injection in the left eye were performed . visual acuity had not improved , and snellen visual acuity was 20 / 80 in each eye . however , one year later , visual acuity was improved , best - corrected snellen visual acuity was 40 / 80 in each eye , and cme was spontaneously improved ( fig . paclitaxel is an anticancer drug used to treat various malignancies including breast and lung cancers . teitelbaum and tresley   have reported a case of macular edema associated with docetaxel use . telander and sarraf   also documented oct findings of cme secondary to docetaxel therapy and treatment with oral acetazolamide because visual acuity was not improved after cessation of docetaxel therapy . they described spontaneous resolution of cme and improvement of visual acuity after a change of chemotherapeutic regimen . our case is the first report to document a case of intravitreal bevacizumab plus triamcinolone injection in cme secondary to paclitaxel use . intravitreal bevacizumab plus triamcinolone injection showed no improving effect on cme secondary to paclitaxel use , and it is suspected that systemic bevacizumab injection was not effective in the prevention and treatment of cme in this case based on the previous chemotherapeutic regimen . cme is usually associated with intraocular inflammation , venous occlusive disease , diabetic retinopathy , and cataract surgery . the pathophysiology of cme in this case is unclear , but we propose that cme secondary to paclitaxel use may be not associated with vascular endothelial grow factor or intraocular inflammation considering the lack of effectiveness of bevacizumab plus triamcinolone . as in the case of joshi and garretson , our study confirmed that macular edema associated with paclitaxel use shows spontaneous resolution and improvement of visual acuity after a change of chemotherapeutic regimen .
we encountered a patient with cystoid macular edema ( cme ) secondary to paclitaxel use . a 57-year - old man presented with gradual decreased bilateral vision . 
 his chemotherapeutic regimen consisted of bevacizumab , paclitaxel ( 175 mg / m2 for 5 months ) , and carboplatin . 
 optical coherence tomography imaging revealed bilateral cme greater than 500 m . 
 however , one year later , visual acuity was improved , best - corrected snellen visual acuity was 40 / 80 in each eye , and cme was spontaneously improved . 
 our study confirmed that macular edema associated with paclitaxel use shows spontaneous resolution and improvement of visual acuity after a change of chemotherapeutic regimen .