Tamoxifen Maculopathy-A Case Report

Abstract

Purpose: To report a case of tamoxifen maculopathy in a 44-year-old female with ovarian endometrioid adenocarcinoma. Method: A case report. Result: A 44-year-old female presented with progressively blurred vision in both eyes for three months. Her past history was significant for ovarian adenocarcinoma, Stage IIIc. After receiving total hysterectomy, she had adjuvant chemotherapy with Taxol (175mg/m^2) and carboplatin (AUC 5) from Nov. 2003 to Feb. 2004. Maintenance therapy with tamoxifen 40-mg-daily dose was given from March 2004 to May 2006. She received a cumulative dose of 32.4g of tamoxifen after surgery. Her best-corrected visual acuity was 30/200 in the right eye and 40/200 in the left eye. Fundus examination revealed bilateral yellow crystalline deposits in the para-macular and foveal areas. Fluorescein angiography showed hyperfluorescence at foveolar region without dye leakage in both eyes. OCT findings include RPE pigment change and decreased parafoveal retinal thickness, without CME. Under the impression of tamoxifen maculopathy, vitamins were given as supplement. At follow-up, crystalline deposits and bilateral visual acuity remained stationary. Conclusion: Tamoxifen treatment can induce ocular toxicity to the cornea, retina, and optic nerve with variable cumulative dosage, which may be reversible after cessation of tamoxifen. We report a case of crystalline maculopathy with a relatively low cumulative dose of tamoxifen. There is no definite treatment for tamoxifen maculopathy. Therefore, regular fundus and visual acuity examination is suggested for patients under tamoxifen therapy.