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Tamoxifen retinopathy.

Fatemeh Bazvand1, Zahra Mahdizad1, Nader Mohammadi1

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Tamoxifen (TAM) retinopathy can affect the eye's retina and choroid. Early detection of TAM-induced retinal toxicity is crucial, with funduscopy and OCT imaging being the most promising screening methods.

Keywords:
ChoroidOCTRetinaRetinopathyTamoxifenToxicity

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Area of Science:

  • Ophthalmology
  • Medical Oncology
  • Pharmacology

Background:

  • Tamoxifen (TAM), a selective estrogen receptor modulator, is a standard treatment for breast cancer.
  • Estrogen receptors are present in ocular tissues, including the retina, retinal pigment epithelium, and choroid, suggesting potential for TAM-related ocular toxicity.
  • Understanding the ocular side effects of TAM is essential for patient monitoring and management.

Purpose of the Study:

  • To review and synthesize reported effects of Tamoxifen on the retina and choroid.
  • To determine the incidence and timeline of Tamoxifen retinopathy.
  • To evaluate potential screening modalities for early detection of TAM-induced ocular toxicity.

Main Methods:

  • Systematic search of medical databases using relevant keywords.
  • Extraction and pooling of data from identified studies.
  • Analysis of reported incidence, exposure times, and clinical findings related to TAM retinopathy.

Main Results:

  • The incidence of retinal and choroidal toxicity associated with Tamoxifen use ranged from 0.9% to 12%.
  • The time to develop Tamoxifen retinopathy varied significantly, from 3 weeks to 13 years of exposure.
  • Functional measurements have not proven effective for screening, despite their potential for assessment.

Conclusions:

  • Tamoxifen can induce toxicity in the retina and choroid, with a variable incidence and onset.
  • There is currently no universally accepted screening method for Tamoxifen retinopathy.
  • Serial funduscopy and optical coherence tomography (OCT) imaging are proposed as the most reasonable approaches for early detection of TAM-induced retinal toxicity.