Long-term tamoxifen citrate use and potential ocular toxicity

Gorin, Michael B.; Day, Richard; Costantino, Joseph P.; Fisher, Bernard; Redmond, Carol; Wickerham, Lawrence; Gomolin, J. E. S.; Margolese, Richard G.; Mathen, Mathen K.; Bowman, D. M. J. S.; Kaufmann, David; Dimitrov, Nikolay V.; Singerman, Lawrence J.; Bornstein, Richard S.; Wolmark, Norman

doi:10.1016/s0002-9394(99)80190-1

Cited by 121 publications

(58 citation statements)

References 24 publications

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“…Clinicians, however, should be aware of the possibility of ocular problems and patients complaining of altered vision should be referred for urgent ophthalmological examination. Some clinicians do suggest regular follow-up (Gorin et al 1998). …”

Section: Tamoxifenmentioning

confidence: 99%

Ocular presentations of breast cancer

Wickremasinghe

Dansingani

Tranos

et al. 2006

Acta Ophthalmologica Scandinavica

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IntroductionBreast cancer is the most common malignancy in women (Office of National Statistics 2002). As ophthalmic manifestations are common, the astute ophthalmologist can instigate the search for primary disease when the first presentation is ophthalmic in nature, or, alternatively, play an important role in detecting the metastatic spread of a known primary. Breast cancer accounts for 29% of new malignancies in women in the UK and is a major cause of mortality and morbidity worldwide.The purpose of this article is to provide a review of the ophthalmic manifestations of breast cancer. The subjects covered include the presenting features of metastatic disease involving the visual systems, treatment modalities and strategies currently available, and the ocular effects and complications of treatment. EpidemiologyIncidence rates of breast cancer have increased over the last decade, rising from 90 to 130 per 100 000 population (1988 versus 1998) (Office of National Statistics 2002). In contrast, mortality rates have remained relatively stable since the 1950s. This increase in the incidence of breast cancer is attributed to more effective screening programmes, although a change in the demographics of developed countries and an increasing elderly population may contribute to the growing incidence. Geographical variations exist in breast cancer incidence rates, with higher rates in Europe, North America and Oceania and lower rates in Asia and Africa (Sasco 2001). Doctors practising in the western world should be familiar with the disease.Male breast cancer is rare. The incidence is 0.8-1.5 cases per 100 000 male population, accounting for 1% of all breast cancer diagnoses (Office of National Statistics 2002; Hodgson et al. 2004). The highest incidence occurs in men aged over 70 years (Kidmas et al. 2005). In families with hereditary breast cancer, younger males may be affected. The BRCA2 gene is often implicated in these cases (Lorenzo Bermejo & Hemminki 2005).Ocular manifestations of male breast cancer can occur and this differential diagnosis should not be overlooked (O'Brien et al. 2000;Silvestris et al. 2003;Dieing et al. 2004). Ophthalmic metastases in breast cancerMetastatic disease to the eye from the breast was first described by Johann ABSTRACT.Context: Breast cancer is the most common malignancy in women, with increasing incidence in Europe and North America. The frequency of involvement of the eye and visual pathways is reported to be as high as 30% in patients with known metastatic disease. In some cases, ophthalmic involvement can be the first sign of metastatic spread. Metastasis occurs via the haematogenous route and predominantly involves the choroid. Metastases to other ocular structures, the orbit and the visual pathways have also been described. Paraneoplastic effects are rare but significant. Treatments: Different modalities are employed in the treatment of breast cancer and its metastases. These include chemotherapy and radiotherapy. The ocular adverse effects of these have been well described,...

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Section: Tamoxifenmentioning

confidence: 99%

Ocular presentations of breast cancer

Wickremasinghe

Dansingani

Tranos

et al. 2006

Acta Ophthalmologica Scandinavica

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“…17 Posterior subcapsular cataract can occur with busulphan, 5,[18][19][20] methotrexate, 5 toremifene and tamoxifen. [21][22][23] In a prospective study of breast cancer patients treated with tamoxifen and toremifene, annual cataract rates were found to be 6.8% and 6.2% respectively.…”

Section: Anterior Segment Side Effectsmentioning

confidence: 99%

Toxicidad ocular de la quimioterapia sistémica anticancerosa

Omoti

2006

Pharmacy pract. (Granada Ed. impr.)

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*The increased use of chemotherapeutic agents has resulted in longer cancer patient survival. Consequently the ophthalmologist is seeing more patients with adverse ocular side effects secondary to these antineoplastic agents. Ocular toxicity induced by cancer chemotherapy includes a broad spectrum of disorders, reflecting the unique anatomical, physiological and biochemical features of the eye. Understanding the ocular side effects will assist the ophthalmologist and oncologist to recognize them early and intervene before blindness occurs. Anticipation of various treatmentrelated toxicities may also provide the opportunity for pharmacists to develop intervention strategies that could minimize or eliminate an expected side effect. The ophthalmologist should examine patients on anticancer therapy at baseline and three monthly thereafter. The various ocular side effects of anticancer chemotherapeutic agents, tamoxifen, and interferon on the adnexia, anterior segment, posterior segment and neuro-ophthalmic structures were reviewed.

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“…Tamoxifen, like U18666A, is a highly lipophilic-amphipathic-ethoxy tertiary amine. Tamoxifen increases the risk of cataracts in treated patients (45,46). U18666A added to lipid membranes at 3-4 mol% both ordered membrane lipids (Table 1, Fig.…”

Section: Discussionmentioning

confidence: 99%

Direct perturbation of lens membrane structure may contribute to cataracts caused by U18666A, an oxidosqualene cyclase inhibitor

Cenedella

Jacob²,

Borchman

et al. 2004

Journal of Lipid Research

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Induction of cataracts in experimental animals is a common toxic feature of oxidosqualene cyclase (OSC) inhibitors. U18666A has been shown to produce irreversible lens damage within a few weeks of treatment. Drug actions, besides reducing the availability of cholesterol, could contribute to cataract formation. Cholesterol added to cultures of lens epithelial cells could only partially overcome the growth-inhibiting effects of U18666A. In view of this finding and the fact that U18666A and other OSC inhibitors are highly lipophilic cationic tertiary amines, we tested the hypothesis that the cataractogenic effect of U18666A is related to direct perturbation of lens membrane structure and function. Based on changes in the anisotropy of fluorescent probes, U18666A incorporated into bovine lens lipid model membranes increased membrane structural order and, using small-angle x-ray diffraction, U18666A was shown to intercalate into the lens lipid model membranes and produce a broad condensing effect on membrane structure. Also, exposure of cultured lens epithelial cells and intact rat lenses to U18666A induced apoptosis. Induction of apoptosis may begin by intercalation of U18666A into cell membranes. By increasing membrane structural order, U18666A may also increase light scatter, thus directly contributing to lens opacification. -Cenedella, R.

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Long-term tamoxifen citrate use and potential ocular toxicity

Cited by 121 publications

References 24 publications

Ocular presentations of breast cancer

Ocular presentations of breast cancer

Toxicidad ocular de la quimioterapia sistémica anticancerosa

Direct perturbation of lens membrane structure may contribute to cataracts caused by U18666A, an oxidosqualene cyclase inhibitor

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