Pseudocystic foveal cavitation in tamoxifen retinopathy

Am J Ophthalmol. 2014 Jun;157(6):1291-1298.e3. doi: 10.1016/j.ajo.2014.02.046. Epub 2014 Feb 26.

Abstract

Purpose: To present 3 cases of tamoxifen-induced foveal cavitation and review previous prospective and cross-sectional studies.

Design: Observational case series.

Methods: Retrospective analysis of patients presenting to a single institution with evidence of tamoxifen-induced maculopathy.

Results: Three patients presented with pseudocystic foveal cavitation similar in appearance to macular telangiectasia type 2 on spectral-domain optical coherence tomography (SD OCT) imaging.

Conclusions: Tamoxifen maculopathy is characterized by cavitation in the central macula with or without typical cystoid macular edema. Pathogenesis involves toxicity to retinal Müller cells. It can occur with low daily and cumulative doses of the drug, and in the absence of subjective visual complaints or crystalline retinopathy. Prospective research with SD OCT imaging will be required to gain a more accurate estimate of the incidence of tamoxifen retinopathy.

Publication types

  • Case Reports
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Chemotherapy, Adjuvant
  • Cysts / chemically induced*
  • Cysts / diagnosis
  • Estrogen Antagonists / adverse effects*
  • Female
  • Fluorescein Angiography
  • Fovea Centralis / drug effects*
  • Fovea Centralis / pathology
  • Humans
  • Macular Edema / diagnosis
  • Middle Aged
  • Retinal Diseases / chemically induced*
  • Retinal Diseases / diagnosis
  • Retrospective Studies
  • Tamoxifen / adverse effects*
  • Tomography, Optical Coherence
  • Visual Acuity / physiology

Substances

  • Estrogen Antagonists
  • Tamoxifen