Abstract
Purpose :
To describe the structural and vascular abnormalities observed in patients with tamoxifen retinopathy and to compare these with macular telangiectasia type 2 abnormalities reported previously in the literature.
Methods :
The medical records of patients who visited the ophthalmology department with a history of taking tamoxifen were reviewed. Tamoxifen retinopathy was diagnosed based on typical spectral domain-optical coherence tomography (SD-OCT) findings, such as intraretinal cavitation and/or photoreceptor disruption. Multimodal imaging including fundus photography, fluorescein angiography (FA), fundus auto-fluorescence (FAF), spectral-domain optical coherence tomography (OCT), and OCT angiography (OCTA) was analyzed.
Results :
Among 292 patients who were screened, 26 patients were diagnosed with tamoxifen retinopathy. Of them, 10 patients (17 eyes) were evaluated using multimodal imaging. All patients were women, with mean age of 62.2 years. They were treated with tamoxifen as adjuvant endocrine therapy for breast cancer. Crystalline deposits were seen in 12 out of the 17 examined eyes (68.8%) throughout the course of the disease. Moreover, FAF imaging showed increased foveal auto-fluorescence in 16 eyes (94.1%), and mixed patterns of increased and decreased FAF signals in 1 eye. OCT abnormalities, including hyporeflective cavities and/or disruption of the photoreceptor line, were observed in all the examined eyes. OCTA examination showed vascular changes, including saccular capillary telangiectasia in 14 eyes (82.4%) and right-angled vessels in 6 eyes (35.3%) predominantly temporal to the fovea, better than FA.
Conclusions :
The morphological characteristics including vascular anomalies of tamoxifen retinopathy are very similar to those observed in the early stages of macular telangiectasia type 2, suggesting a common pathogenesis between the 2 diseases.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.