Tamoxifen maculopathy

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    Tamoxifen maculopathy


    Crystalline deposits and neurosensory retinal cavitary changes can develop in both tamoxifen retinopathy and nonproliferative idiopathic macular telangiectasia type 2 (Mac Tel2). Mac Tel2 is typically differentiated from tamoxifen retinopathy based on the presence of late leakage and mid-phase telangiectatic vessels on fluorescein angiography (FA) and the presence of hyperautofluorescence. Unlike Mac Tel2, tamoxifen retinopathy is known to be a progressive disease and the cessation of tamoxifen results in resolution of retinopathy. We report a unique case of nonproliferative Mac Tel2 in a 36-year-old Hispanic woman with tamoxifen use and the vision outcome 30 months after cessation of tamoxifen. The FA and optical coherence tomography angiography findings of this patient support the diagnosis of Mac Tel2, but her cessation of tamoxifen led to partial reversal of the topographic findings and improvement in visual acuity. This patient is also unique in the unusually young age of presentation for Mac Tel2. Karger AG, Basel Tamoxifen retinopathy usually manifests as crystalline maculopathy with or without cystoid macular edema (CME) [1, 2]. Our case supports that there are common pathways in the pathogenesis of tamoxifen retinopathy and Mac Tel2, and tamoxifen use could potentially accelerate foveal atrophy in patients with Mac Tel2. With the introduction of optical coherence tomography (OCT), structural changes in the fovea evidenced by loss of outer retinal layers or cavitation of inner retinal layers or outer retinal layers have been described [3-7]. Chloroquine and its derivative, hydroxychloroquine sulfate, which have been useful in treating malaria and in larger doses, collagen-vascular disease, cause a cumulative dose-related pigmentary retinopathy. Inhibition of critical enzymes & interference with the metabolic functions of retinal pigment epithelium (RPE) & photoreceptors. Both drugs apparently have a selective affinity for melanin, so it gets concentrated in RPE & uveal tissue & is retained for long periods, even after its usage is stopped. Accumulation of pigment laden cells in outer retinal layers 3. The earliest histopathologic change, even before RPE damage, appears to be membranous cytoplasmic bodies in ganglion cells and degenerative changes in photoreceptor outer segments. Damage & reduction of photoreceptors It increases with daily dose & duration & varies from 1-28% without any predilection for any particular age, sex or race. Symptoms: can be asymptomatic Earliest symptoms - difficulty in reading/ fine tasks due to central / paracentral scotomas Gradually these enlarge & involve fixation, reducing visual acuity later. Other symptoms- metamorphopsia, red-green haloes, cycloplegia, amblyopia, photophobia, flickering of yellow lights. Ocular signs cornea – vortex keratopathy - consists of grayish or golden brown corneal epithelial deposits.

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    A 64-YEAR-OLD woman complained of gradual blurring of vision. Her visual acuity was 20/60 OU. Biomicroscopic examination demonstrated no anterior. In such cases, the ocular side effects from tamoxifen could be profound. if the patient is on a high dose of tamoxifen and exhibits chronic maculopathy, there is. Tamoxifen. It's a nonsteroidal estrogen antagonist used in treatment of advanced breast carcinoma & as adjuvant therapy after.

    Correspondence Address: Nirmala Srikantia Department of Radiation Oncology, M. Ramaiah Medical Teaching Hospital, MSR Nagar, MSRIT Post, Gokula, Bangalore - 560 054 India Source of Support: None, Conflict of Interest: None Tamoxifen is a selective estrogen receptor modulator widely used in the treatment of hormone-responsive breast cancer. Tamoxifen-induced ocular complications are very rare. A post-menopausal woman, diagnosed and treated case of carcinoma of left breast, on follow-up presented with history of gradual diminution of vision in both eyes of 3 months duration. Patient was on tamoxifen therapy 20 mg daily for the last 2 years. Fluorescein angiography, ocular coherence tomography confirmed the diagnosis. Although ocular toxicity is rare, careful evaluation of patients with visual symptoms on tamoxifen therapy is required. Keywords: Breast cancer, crystalline maculopathy, ocular toxicity, tomoxifen therapy How to cite this URL: Srikantia N, Mukesh S, Krishnaswamy M. Crystalline maculopathy: A rare complication of tamoxifen therapy. J Can Res Ther [serial online] 2010 [cited 2019 Feb 27];3-5. 2010/6/3/313/73332Tamoxifen is a selective estrogen receptor modulator. It is an amphiphilic agent that can accumulate in lysosomes and cause oxidative damage. Unter Therapie mit Tamoxifen tritt bei 0,6–12% der behandelten Patienten eine Schädigung okulärer Strukturen auf. Diese zeichnet sich klassischerweise durch einen ausgeprägten Visusverlust bei kristallinen glitzernden Einlagerungen in die Makula mit Makulaödem oder durch kristalline Einlagerungen in die periphere Retina aus. Wir berichten über eine 55-jährige Patientin mit seit 10 Monaten bestehender Visusreduktion (OD und OS cc 0,2) bei Mammakarzinom und ossärer Metastase, die seit 7 Jahren eine Tamoxifentherapie (20 mg/Tag) erhielt. Funduskopisch bestand beidseits eine Papillenexkavation von 0,5 bei bekanntem primär chronischem Offenwinkelglaukom (PCOWG). In der optischen Kohärenztomographie (OCT) des rechten Auges zeigte sich ein zystoides Areal im Foveabereich mit fokaler lamellärer Disruption der Photorezeptorschicht ohne Anhalt für Makulaödem oder -verdickung. In der 30-II-Perimetrie des rechten Auges zeigte sich mit einer „mean deviation“ (MD) von 6,2 d B ein glaukomtypisches bogenförmiges Absolutskotom ohne Verbindung zum blinden Fleck. Das Gesichtsfeld des linken Auges war unauffällig (MD 1,1 d B).

    Tamoxifen maculopathy

    Common Medications That May Be Toxic to the Retina, Watch for Ocular Effects of Breast Cancer Drugs - American.

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  7. Tamoxifen ist ein kompetitiver Hemmstoff am Östrogenrezeptor, der in der adjuvanten Therapie des Mammakarzinoms eingesetzt wird 8. Bei 0,6–12%

    • Ungewöhnliches Erscheinungsbild einer tamoxifenassoziierten..
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    Oct 21, 2015. PDF Introduction Tamoxifen citrate is an anti-estrogen agent used in the treatment of breast carcinoma. Crystalline maculopathy is a rare. Sep 17, 2015. Purpose. To present a case of tamoxifen retinopathy on a 57-year-old woman. Tamoxifen maculopathy revisited a case report. J Ocul. Srikantia N, Mukesh S, Krishnaswamy M. Crystalline maculopathy A rare complication of tamoxifen therapy. J Can Res Ther 2010;3-5.

     
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