Optical coherence tomography angiography measurements in tamoxifen associated retinopathy: a systematic review and...

To evaluate the evidence for tamoxifen induced alterations of retina blood flow in macula region, using Optical Coherence Tomography Angiography (OCTA).

A systematic review of PubMed, Google Scholar, Scopus, Web of Science, Cochrane, and Embase databases, including quality assessment of published studies, investigating the alterations of OCTA parameters in Tamoxifen Associated Retinopathy (TAR) was conducted. The outcomes of interest comprised alternations of Vascular Densities (VD) in Superficial and Deep capillary plexus (SCP and DCP) of fovea and parafovea, Telangiectatic vessels (TL), and the Right-Angled Vessels (RAVs).

From the total of 680 articles obtained from the databases, the pool of papers was narrowed down to studies published until May 2024. Lastly, 5 studies were included. Our analysis demonstrated that 80% (95%CI: 63-97%) and 33% (95%CI: 23-44%) of patients on tamoxifen would manifest TL and RAVs in their OCTA, respectively. Tamoxifen patients had lower DCP-F and SCP-F vessel densities; however, only the drop in DCP-F vessel density was statistically significant (MD: -0.46, CI: -0.90 to - 0.01, p-value: 0.04).

Our results show that OCTA findings such as RAV and TL and vascular density DCP-F have been significantly altered compared to healthy controls. These findings demonstrate how OCTA can provide a non-invasive assessment of tamoxifen effects on the retinal microvasculature, potentially serving as a trustworthy biomarker for more accurate TAR identification and monitoring.