Tamoxifen retinopathy

Abstract

Abstract Purpose To report a rare and interesting case of retinopathy secondary to tamoxifen therapy. Setting: Tamoxifen is a selective estrogen receptor modulator widely used in the treatment of hormone‐responsive breast cancer. Methods A 38‐year‐old white woman underwent right breast cancer quadrantectomy with axillary lymph node dissection. She was started on long term tamoxifen (20 mg daily). Results After a total dose of 29.2 g of Tamoxifen over a period of 48 months, she complained of blurred vision. Her corrected visual acuity was 0.3 in the right eye and 0.1 in the left eye. The retinography showed yellowish‐white deposits, more heavily concentrated in the inferior and temporal macular area. A greyish alteration following the vascular arcade with some pigment changes were detected. Fundus autofluorescence showed bilateral paramacular rings of hypofluorescence and a central increased autofluorescence in the macula (punctate spots with bright autofluorescence signal) which was not clearly visible on fundus photography. Many hypofluorescence areas following the vascular arcade were detected. Retinopathy was diagnosed and tamoxifen was discontinued. Conclusion Patients treated with tamoxifen who complain of visual problems should be immediately referred to an ophthalmological examination. In some cases, the retinopathy is not limited to the macula.