Tamoxifen and ocular toxicity

Tamoxifen, widely used in the management of breast cancer, has been associated with a reduction of mortality and recurrence as well as occurrence of controlateral tumors. It is generally well tolerated, apart from certain well-documented adverse effects concerning mainly the reproductive organs, the most worrying being its carcinogenicity for the endometrium. Ocular toxicity has also been reported as one possible complication of the drug, with lesions described in the retina, the cornea, or the optic nerve, especially in women treated with high daily or cumulated doses of tamoxifen, although some cases have also been reported with standard doses. The incidence of such ocular complications is rather low considering the large number of patients receiving tamoxifen. The possible reversibility of these lesions, if discovered in time, emphasizes the need for clinicians to be aware of these ocular reactions and raises the question of periodic ophthalmological screening examinations among patients receiving tamoxifen.