Simple SummaryThe study’s purpose was to determine whether neurotoxic signs in breast cancer patients receiving taxane (paclitaxel) chemotherapy correlate with retinal or corneal nerve changes in a longitudinal study combining oncological examinations with advanced biophotonic imaging techniques. Recruited breast cancer patients underwent regular monitoring sessions including the clinical assessment of their quality of life and neurological scores, ophthalmological status, retinal optical coherence tomography, and large area confocal laser scanning microscopy of their corneal subbasal nerve plexus (SNP). The study revealed two key breakthroughs: an observable increase in retinal thickness and the examination of identical corneal SNP large-area mosaics over time. Consequently, advanced biophotonic imaging techniques could represent a powerful diagnostic tool for the objective assessment of the severity of adverse events, wherein oncologists and ophthalmologists could benefit from each other, leading to a better outcome for the patient.AbstractA common severe neurotoxic side effect of breast cancer (BC) therapy is chemotherapy-induced peripheral neuropathy (CIPN) and intervention is highly needed for the detection, prevention, and treatment of CIPN at an early stage. As the eye is susceptible to neurotoxic stimuli, the present study aims to determine whether CIPN signs in paclitaxel-treated BC patients correlate with ocular changes by applying advanced non-invasive biophotonic in vivo imaging. Patients (n = 14, 10 controls) underwent monitoring sessions after diagnosis, during, and after therapy (T0-T3). Monitoring sessions included general anamnesis, assessment of their quality of life, neurological scores, ophthalmological status, macular optical coherence tomography (OCT), and imaging of their subbasal nerve plexus (SNP) by large-area confocal laser-scanning microscopy (CLSM). At T0, no significant differences were detected between patients and controls. During treatment, patients’ scores significantly changed while the greatest differences were found between T0 and T3. None of the patients developed severe CIPN but retinal thickenings could be detected. CLSM revealed large SNP mosaics with identical areas while corneal nerves remained stable. The study represents the first longitudinal study combining oncological examinations with advanced biophotonic imaging techniques, demonstrating a powerful tool for the objective assessment of the severity of neurotoxic events with ocular structures acting as potential biomarkers.