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Ocular toxicity in low-dose tamoxifen: a prospective study
B N Noureddin1, M Seoud, Z Bashshur
1Department of Ophthalmology, American University of Beirut, Lebanon. bndean@aub.edu.lb
Eye (London, England)
|March 9, 2000
Summary
Low-dose tamoxifen can cause ocular toxicity, including keratopathy and retinopathy, in 12% of patients. Early detection through regular eye exams is crucial for reversible visual side effects.
Area of Science:
- Ophthalmology
- Medical Oncology
- Pharmacology
Background:
- Tamoxifen is a widely used medication for breast cancer treatment.
- Potential ocular side effects of tamoxifen necessitate careful monitoring.
Purpose of the Study:
- To determine the incidence, symptoms, progression, and reversibility of ocular toxicity associated with low-dose tamoxifen therapy.
- To investigate the relationship between tamoxifen dosage, treatment duration, and the occurrence of ocular side effects.
Main Methods:
- Prospective follow-up of 65 women with breast cancer receiving oral tamoxifen (20 mg/day).
- Regular ophthalmic evaluations every six months for a median of 30 months.
- Assessment for toxicity in the cornea, lens, retina, and optic nerve, irrespective of visual acuity changes.
Main Results:
- Ocular toxicity was observed in 12% (8 out of 65) of patients.
- Common findings included keratopathy (subepithelial deposits, whorls, linear opacities) and pigmentary retinopathy.
- One patient developed optic neuritis. Higher cumulative tamoxifen dose and longer treatment duration were associated with increased toxicity risk. Keratopathy resolved upon drug discontinuation.
Conclusions:
- Low-dose tamoxifen can lead to reversible ocular toxicities, including keratopathy and retinopathy.
- Patients on tamoxifen require prompt symptom reporting and annual ophthalmic examinations for early detection and management of reversible visual complications.