OCT image of an 58-year-old woman with a bilateral tamoxifen maculopathy. She had taken tamoxifen for 24 months due to breast cancer. In spite of discontinuation 2 years ago, her macula remained unchanged. Her best-corrected visual acuity was 20/50 in the right and 20/100 in the left. Tamoxifen is a drug given to women who have had breast cancer, to help keep the cancer from coming back. It works by preventing estrogen from binding to breast-cancer cells; this blocking discourages the cells' growth. S., the drug is prescribed, after surgery, radiation treatment, and chemotherapy, to nearly all women with invasive breast cancer if their cancer is sensitive to estrogen. (About 75 percent of the 300,000 new breast-cancer cases each year are estrogen-sensitive). At present, the usual dose of tamoxifen for women with early-stage cancer is 20 mg per day, taken for five years. This means that over a million American women are on tamoxifen at any given time. New studies show that more lives might be saved if it is taken for ten years, so even more women will be taking the drug in the future. Tamoxifen is also sometimes prescribed preventatively for women at very high risk of breast cancer, for example, those carrying a BRCA mutation. The trouble with tamoxifen is that the drug acts on other tissues in addition to breast cancer.
Article There are a number of medications that can be toxic to the eye. While the adverse effects of many of these are reversible upon drug cessation if detected early enough, others cause irreversible harm. Retinal physicians must employ their clinical acumen, as well as a host of imaging technologies including fluorescein angiography (FA), optical coherence tomography (OCT), ultrasonography, perimetry, electroretinography (ERG), and even fundus autofluorescence (FAF), to detect the earliest signs of retinal and uveal drug toxicity. This review discusses the major classes and prototypical drugs that cause retinal and uveal toxicity, organized by the anatomic locations they affect. Tamoxifen is a first-generation selective estrogen receptor modulator that has revolutionized the management of breast cancer. Currently, it is used to treat early and advanced stages of estrogen-receptor–positive breast cancer in pre- and postmenopausal women. Intraretinal crystalline deposits, corneal opacities, macular edema, and focal fundus pigmentary changes, along with decreased visual acuity (VA), have been linked with tamoxifen doses greater than 60 mg/m Upon clinical examination, crystalline deposits appear to be located in the inner retina, most commonly within the parafoveal area (Figure 1). Download PDF When a patient with an eye condition walks into an ophthalmologist’s office, the fact that she has been treated for breast cancer may not raise warning flags for the clinician. But there’s accumulating evidence that ocular conditions such as dry eye, retinopathy, and cataracts may be at least partly due to some breast cancer medications. Only a small percentage of breast cancer patients experience clinically evident ocular side effects from their medications. Nevertheless, because these drugs are so widely used, the related eye conditions may affect many women. The breast cancer medication most commonly identified with ocular side effects is tamoxifen. However, chemotherapy agents, such as 5-fluorouracil (5-FU), can also have ocular side effects. And more researchers are becoming concerned that the drugs known as aromatase inhibitors, which now are often prescribed as adjuvant endocrine therapy, may also have adverse effects on the eye, including small retinal hemorrhages, increased incidence of floaters, and dry eye.
Действующее вещество Тамоксифена цитрат Tamoxifen citrate. Тамоксифен — это нестероидный противоопухолевый антиэстрогенный препарат, характеризующийся. Tamoxifen is a selective estrogen receptor modulator SERM and acts against breast cancer byThese hemorrhages may be the result of excessive traction on the retina, caused by estrogen.