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Hyun-Ah Kim, Suhwan Lee, Young Hee Yoon; Prevalence of tamoxifen retinopathy and its risk factors. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3538. doi: https://doi.org/.
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Breast cancer is the most common cancer in women, and tamoxifen has been widely used in hormone-receptor positive patients. Because the prevalence of tamoxifen retinopathy or its risk factors remain unknown, we conducted this retrospective cohort study.
We analyzed medical records of female breast cancer patients who had received tamoxifen and undergone OCT examination between January 2007 and November 2017. The diagnosis of tamoxifen retinopathy was based on characteristic findings including intraretinal cavitations on OCT, or hyperreflective deposits on both fundus photograph and OCT. Only the patients who received tamoxifen for more than 24 months before the last OCT examination were included in the study. Patients who received other medications that may develop crystalline retinopathy, or have severe structural deformation in the macula due to any other causes were excluded.
A total of 251 patients were finally selected for analysis. All patients were on the low-dose regimen for tamoxifen (20 mg/day). Of the 251 patients analyzed, 30 (12.0%) patients developed tamoxifen retinopathy. Among them, 27 patients had intraretinal cavitations, 3 had hyperreflective spots, and 15 had both. Mean age at initiation of tamoxifen use was 48.3±9.1 (range 32-67) years for patients with tamoxifen retinopathy and 47.5±8.8 (range 24-83) years for those without. For tamoxifen retinopathy patients, mean duration of tamoxifen intake was 53.5±10.9 (range 28-69) months, and mean cumulative dose of tamoxifen was 32.6±6.7 (range 17.0-41.9) grams. For patients without tamoxifen retinopathy, mean duration of tamoxifen intake was 54.3±11.8 (range 25-99) months, and mean cumulative dose of tamoxifen was 33.0±7.3 (range 11.5-60.2) grams. Body mass index (BMI) was significantly higher in patients who developed tamoxifen retinopathy (24.4±3.4 kg/m2 vs. 23.0±3.2 kg/m2, P = 0.023). Also, the presence of hyperlipidemia was significantly higher in the tamoxifen retinopathy patients (33.3% vs. 14.0%, P = 0.015). The cumulative dose of tamoxifen, the duration of treatment, or menopausal status were not associated with the development of tamoxifen retinopathy.
Using the high resolution OCT for the diagnosis of tamoxifen retinopathy, the prevalence of tamoxifen retinopathy seems to be higher than previously reported. In our study, higher BMI and hyperlipidemia were found more frequently in patients who developed tamoxifen retinopathy.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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