Severe visual loss after a single dose of vincristine in a patient with spinal cord astrocytoma.

A case of severe visual loss following a single dose of vincristine is described. The primary pathology was a spinal cord astrocytoma, grade II, with no intracranial extension. Visual loss after a single small dose of vincristine has never been reported. While peripheral neuropathy and cranial nerve involvement is common, optic neuropathy is extremely rare. The literature of vincristine optic nerve toxicity is reviewed. Although differential diagnostic alternatives can be considered in all described cases it is very likely that vincristine does cause severe visual loss in a small number of patients.