Macular oedema due to letrozole: A first case report

Moschos, Marilita M.; Chatziralli, Irini; Zagouri, Flora; Zografos, George

doi:10.1111/j.1444-0938.2012.00771.x

Cited by 12 publications

(5 citation statements)

References 16 publications

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“…Some patients with idiopathic uveitis may respond to a course of topical corticosteroid drops, and this cannot be ruled out. Macular edema was previously reported in a 72-year-old patient receiving letrozole, another AI, for 3 years, but review of the photographs show a pigment epithelial detachment that resolved with ranibizumab, so the patient may have had exudative age-related macular degeneration. Some authors theorized that depriving the retina of estrogen’s neuroprotective effects leads to breakdown of the blood-retinal barrier .…”

Section: Discussionmentioning

confidence: 86%

“…Macular edema was previously reported in a 72-year-old patient receiving letrozole, another AI, for 3 years, but review of the photographs show a pigment epithelial detachment that resolved with ranibizumab, so the patient may have had exudative age-related macular degeneration. Some authors theorized that depriving the retina of estrogen’s neuroprotective effects leads to breakdown of the blood-retinal barrier . This breakdown, implicated in diabetic retinopathy, age-related macular degeneration, and uveitis, often results in macular edema.…”

Section: Discussionmentioning

confidence: 86%

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Association of Uveitis and Macular Edema With Anastrozole Therapy

2018

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serving as the principal investigator for an investigator-initiated study funded by Horizon Pharmaceuticals through a grant to DINORA Inc, a 501(c)(3) entity; being a member of the executive board of OMERACT (Outcome Measures in Rheumatology), an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; being a member of the American College of Rheumatology's (ACR's) Annual Meeting Planning Committee; being chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; being a member of the Veterans Affairs Rheumatology Field Advisory Committee; and being the editor and director of the University of Alabama at Birmingham Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. No other disclosures were reported.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 86%

Association of Uveitis and Macular Edema With Anastrozole Therapy

2018

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“…The therapy consisted of difluprednate eye drops and resulted in an almost complete resolution of symptoms. Letrozole, which is another commonly used AI, has also been reported to inflict macular oedema [ 9 ]. Ocular coherence tomography showed intraretinal fluid and a significant increase in retinal thickness in the foveal and parafoveal areas.…”

Section: Reviewmentioning

confidence: 99%

Review of the Literature on Ocular Complications Associated With Aromatase Inhibitor Use

Almafreji

Smith

Peck³

2021

Cureus

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Aromatase inhibitors (AIs), such as anastrozole, letrozole, and exemestane, are commonly used as adjuvant endocrine therapy in hormone-receptive breast cancer in postmenopausal women. Their adverse effects are well documented, except for visual disturbances. The purpose of this study was to review the current literature on ocular disease linked to AI use. Due to the scarcity of published data, any suggested ophthalmic adverse events were included to increase awareness of these drugs. The ocular side effects of tamoxifen use are well documented and were not included. Cases of rare side effects such as papilloedema, macular oedema, and uveitis associated with anastrozole and letrozole have been reported. Studies demonstrating retinopathy, in the form of crystalline retinopathy, hemicentral retinal artery occlusion, and retinal haemorrhages, are also noted. All three third-generation AIs can also lead to ocular surface diseases such as corneal epithelial changes, blepharitis, and keratitis. There is slightly more literature available regarding anastrozole-related ocular diseases. Although these are likely rare side effects, we recommend a high level of clinical suspicion when assessing patients with visual symptoms and on AIs. Larger prospective studies are necessary to further investigate these complications.

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“…In the literature, there are case reports of CME induced by the use of aromatase inhibitors[ 4 ] as well as a case report of CME caused by letrozole. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

A case report on letrozole-related maculopathy

Azeem,

Al Hinai,

Al Kharousi

et al. 2023

Oman Journal of Ophthalmology

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Letrozole is an oral aromatase inhibitor used in the treatment of hormone receptor-positive breast cancers in postmenopausal women. It acts by inhibiting the conversion of androgens to estrogen thereby lowering the estrogen synthesis in the body. We report a case of bilateral cystoid macular edema (CME) in a postmenopausal woman on letrozole for breast cancer. A 62-year-old female presented with painless gradually progressive bilateral diminution of vision for the past 6 months. Her previous ocular history is unremarkable. Her medical history is known for carcinoma of the breast for which she underwent chemotherapy followed by mastectomy, adjuvant hormonal therapy, and radiotherapy. The patient had been on letrozole for the past 4½ years. At presentation, the best corrected visual acuity in the right eye was 0.4 and 0.5 in the left eye. Fundus examination revealed significant bilateral CME. Optical coherence tomography and fundus fluorescein angiography confirmed the diagnosis. After discussing the possibility of letrozole-related maculopathy with the treating oncologist, letrozole was discontinued and the patient was reassessed. Reduction of macular edema and mild visual improvement was observed when letrozole was subsequently stopped. Although ocular side effects are rare with letrozole, a comprehensive ophthalmic evaluation is recommended for patients who present with visual disturbances for prompt intervention.

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Macular oedema due to letrozole: A first case report

Cited by 12 publications

References 16 publications

Association of Uveitis and Macular Edema With Anastrozole Therapy

Association of Uveitis and Macular Edema With Anastrozole Therapy

Review of the Literature on Ocular Complications Associated With Aromatase Inhibitor Use

A case report on letrozole-related maculopathy

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