J Korean Ophthalmol Soc.  2016 Oct;57(10):1656-1660. 10.3341/jkos.2016.57.10.1656.

To Report a Case of Tamoxifen-induced Retinopathy Diagnosed Using Spectral Domain Optical Coherence Tomography

Affiliations
  • 1Department of Ophthalmology, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea. Kimdk89@empas.com

Abstract

PURPOSE
To report a case of tamoxifen-induced retinopathy diagnosed using spectral domain optical coherence tomography (SD-OCT).
CASE SUMMARY
A 44-year-old female presented with metamorphopsia in the left eye and binocular vision loss which started 5 months prior. She had no record of external trauma, diabetes or high blood pressure; however, she had been taking 21.9 g tamoxifen (20 mg/day) since October 2012 after a surgery of her left breast due to cancer. On the initial visit, fundus photography showed crystalline dot-like deposits in both parafoveae. Additionally, fluorescence angiography revealed a small leakage around the macular area. Optical coherence tomography (OCT) was obtained to differentiate from other diseases because fundus photography showed crystalline retinopathy. The OCT revealed a normal right eye but the left macula had a microcystic lesion. Based on the diagnosis of tamoxifen-induced retinopathy, the patient stopped taking tamoxifen. Three months after discontinuation of tamoxifen, fundus photography showed slightly decreased crystalline deposits in the parafoveal area and visual acuity of the right eye was slightly improved. However, SD-OCT showed a slightly aggravated disruption of the outer retina in both eyes.
CONCLUSIONS
Although retinopathy caused by treatment with tamoxifen occurs infrequently, to prevent complications and irreversible damage, patients who take tamoxifen for medical purposes need to undergo a regular ophthalmologic examination.

Keyword

Crystalline dot-like deposits; Microcystic lesion; Spectral domain optical coherence tomography (SD-OCT); Tamoxifen-induced retinopathy

MeSH Terms

Adult
Breast
Crystallins
Diagnosis
Female
Fluorescein Angiography
Humans
Hypertension
Photography
Retina
Tamoxifen
Tomography, Optical Coherence*
Vision Disorders
Vision, Binocular
Visual Acuity
Crystallins
Tamoxifen

Figure

  • Figure 1. Fundus photography and spectral domain optical coherence tomography (SD-OCT) examination. At patient's first visit, fundus photography shows crystalline dot-like deposits in parafoveal area (A, B). SD-OCT shows normal finding in the right eye and cyst-like lesion and disruption of the outer retina in the left eye (C, D).

  • Figure 2. Fundus photography and spectral domain optical coherence tomography (SD-OCT) examination. Three months after cessation of tamoxifen, fundus photography shows slightly decreased crystalline deposits in parafoveal area (A, B). SD-OCT shows slightly aggravated cyst-like lesion and disruption of the outer retina in both eye (C, D).


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