To Report a Case of Tamoxifen-induced Retinopathy Diagnosed Using Spectral Domain Optical Coherence Tomography

Jin Young Kwon; Do Gyun Kim

doi:10.3341/jkos.2016.57.10.1656

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Kwon and Kim: To Report a Case of Tamoxifen-induced Retinopathy Diagnosed Using Spectral Domain Optical Coherence Tomography

Case Report

J Korean Ophthalmol Soc 2016;57(10):1656-1660.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.10.1656

To Report a Case of Tamoxifen-induced Retinopathy Diagnosed Using Spectral Domain Optical Coherence Tomography

Jin Young Kwon, MD, Do Gyun Kim, MD, PhD

Department of Ophthalmology, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea

Address reprint requests to Do Gyun Kim, MD, PhD Department of Ophthalmology, Seonam University Myongji Hospital, #55 Hwasu-ro 14beon-gil, Deogyang-gu, Goyang 10475, Korea Tel: 82-31-810-6250, Fax: 82-31-810-0500 E-mail: Kimdk89@empas.com

Received 4 May 2016 Accepted 30 September 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of tamoxifen-induced retinopathy diagnosed using spectral domain optical coherence tomography (SD-OCT).

Case summary

A 44-year-old female presented with metamorphopsia in the left eye and binocular vision loss which started 5 months prior. She had no record of external trauma, diabetes or high blood pressure; however, she had been taking 21.9 g tamoxifen (20 mg/day) since October 2012 after a surgery of her left breast due to cancer. On the initial visit, fundus photography showed crystalline dot-like deposits in both parafoveae. Additionally, fluorescence angiography revealed a small leakage around the macular area. Optical coherence tomography (OCT) was obtained to differentiate from other diseases because fundus photography showed crystalline retinopathy. The OCT revealed a normal right eye but the left macula had a microcystic lesion. Based on the diagnosis of tamoxifen-induced retinopathy, the patient stopped taking tamoxifen. Three months after discontinuation of tamoxifen, fundus photography showed slightly decreased crystalline deposits in the parafoveal area and visual acuity of the right eye was slightly improved. However, SD-OCT showed a slightly aggravated disruption of the outer retina in both eyes.

Conclusions

Although retinopathy caused by treatment with tamoxifen occurs infrequently, to prevent complications and irre-versible damage, patients who take tamoxifen for medical purposes need to undergo a regular ophthalmologic examination.

Keywords: Crystalline dot-like deposits, Microcystic lesion, Spectral domain optical coherence tomography (SD-OCT), Tamoxifen-induced retinopathy

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Figure 1.

Fundus photography and spectral domain optical coherence tomography (SD-OCT) examination. At patient's first visit, fundus photography shows crystalline dot-like deposits in parafoveal area (A, B). SD-OCT shows normal finding in the right eye and cyst-like lesion and disruption of the outer retina in the left eye (C, D).

Figure 2.

Fundus photography and spectral domain optical coherence tomography (SD-OCT) examination. Three months after cessation of tamoxifen, fundus photography shows slightly decreased crystalline deposits in parafoveal area (A, B). SD-OCT shows slightly aggravated cyst-like lesion and disruption of the outer retina in both eye (C, D).

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