Tamoxifen retinopathy: A comprehensive review

Tenney, S.M.; Oboh-Weilke, Aruoriwo; Wagner, David H.; Chen, Mike Yuan

doi:10.1016/j.survophthal.2023.07.003

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…Tamoxifen retinopathy can present in several forms 4-8,11−14 and similarities with macular telangiectasia, type 2 have been noted in previous studies 1,15 Therefore, the macular abnormalities observed on OCT in tamoxifen users may be recognized as a different condition, rather than tamoxifen maculopathy. Furthermore, this maculopathy has not been adequately recognized by ophthalmologists due to limited awareness; thus, it is likely that it has been misdiagnosed as other macular conditions such as macular degeneration and macular edema than toxic maculopathy.…”

Section: Discussionmentioning

confidence: 76%

“…3 However, the therapeutic bene ts of tamoxifen are not without potential ocular complications, particularly those affecting the macula. 1,2,[4][5][6][7] Recent studies have focused on the risk and associated factors of maculopathy, prompting the need for comprehensive investigations into the risk factors and incidence rates of ocular complications associated with this widely prescribed drug. 1,8 The ocular side effects of tamoxifen, speci cally tamoxifen-related retinopathy (maculopathy), have raised concerns among prescribing physicians and ophthalmologists.…”

Section: Introductionmentioning

confidence: 99%

“…Tamoxifen, a selective estrogen receptor modulator, has long been a cornerstone in the treatment of hormone receptor-positive breast cancer. 1,2 Its e cacy in reducing the risk of recurrence and mortality in breast cancer patients is well established. 3 However, the therapeutic bene ts of tamoxifen are not without potential ocular complications, particularly those affecting the macula.…”

Section: Introductionmentioning

confidence: 99%

“…1,2,[4][5][6][7] Recent studies have focused on the risk and associated factors of maculopathy, prompting the need for comprehensive investigations into the risk factors and incidence rates of ocular complications associated with this widely prescribed drug. 1,8 The ocular side effects of tamoxifen, speci cally tamoxifen-related retinopathy (maculopathy), have raised concerns among prescribing physicians and ophthalmologists. Alterations in the retina are reported to manifest in approximately 12% of individuals who have been using a daily dose of 20 mg of tamoxifen for a period exceeding two years, 8 corresponding to a cumulative dose of approximately 15 g. These alterations include the presence of crystalline deposits, telangiectasia, hyperre ective deposits in the inner retinal layers, pseudocystic foveal cavitation, and cystoid macular edema.…”

Section: Introductionmentioning

confidence: 99%

“…Alterations in the retina are reported to manifest in approximately 12% of individuals who have been using a daily dose of 20 mg of tamoxifen for a period exceeding two years, 8 corresponding to a cumulative dose of approximately 15 g. These alterations include the presence of crystalline deposits, telangiectasia, hyperre ective deposits in the inner retinal layers, pseudocystic foveal cavitation, and cystoid macular edema. 1,2 Understanding the demographic and clinical characteristics of individuals at a higher risk of developing maculopathy is crucial for identifying preventive measures and optimizing patient care.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Maculopathy in Tamoxifen Users: Drug Exposure and Risk Factors

Kwon,

Kim,

Ahn

2024

Preprint

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Tamoxifen, a pivotal therapy for hormone receptor-positive breast cancer, is known for its efficacy in reducing breast cancer recurrence and mortality. However, concerns about potential ocular complications, particularly maculopathy, have emerged. This study aims to investigate the risk and associated factors of diverse macular conditions in tamoxifen users, considering drug exposure, demographics, and systemic diseases. A nationwide cohort of tamoxifen users, comprised of 14,267 tamoxifen users, was analyzed using the Health Insurance Review and Assessment (HIRA) database in South Korea. Demographic and clinical characteristics were examined, and the cumulative incidence of macular diseases was stratified by age and cumulative tamoxifen dosage. Hazard ratios were calculated for risk factors, including age, sex, and systemic diseases affecting drug metabolism. Cumulative incidences of overall macular diseases, other maculopathy excluding common macular diseases, and macular edema were 26.4%, 11.4%, and 6.5%, respectively. The risk increased with age and cumulative tamoxifen dosage. Significant risk factors included age, sex, diabetes, hypertension, and kidney disease whereas dyslipidemia and liver disease showed no significant association with the macular conditions. Tamoxifen-induced maculopathy poses a concern for prescribing physicians and ophthalmologists, and this study provides valuable insights into its risk and risk factors. The complex interplay between age, cumulative tamoxifen dosage, and systemic diseases highlights the need for vigilant monitoring and screening strategies. This study may contribute to evidence-based guidelines for tamoxifen maculopathy screening, emphasizing the importance of considering multiple factors for recommendation on screening timing and frequency.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk of Maculopathy in Tamoxifen Users: Drug Exposure and Risk Factors

Kwon,

Kim,

Ahn

2024

Preprint

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Tamoxifen protects photoreceptors in the sodium iodate model

Lee,

Bell,

Anderson

et al. 2024

Experimental Eye Research

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Drug exposure and risk factors of maculopathy in tamoxifen users

Kwon,

Kim,

Ahn

2024

Sci Rep

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Tamoxifen, a pivotal therapy for hormone receptor-positive breast cancer, is known for its efficacy in reducing breast cancer recurrence and mortality. However, concerns about potential ocular complications, particularly maculopathy, have emerged. This study aims to investigate the risk and associated factors of diverse macular conditions in tamoxifen users, considering drug exposure, demographics, and systemic diseases. A nationwide cohort of tamoxifen users, comprised of 14,267 tamoxifen users, was analyzed using the health insurance review and assessment database in South Korea. Demographic and clinical characteristics were examined, and the cumulative incidence of macular diseases was stratified by age and cumulative tamoxifen dosage. We conducted logistic regression analysis to identify potential risk factors among clinical variables such as age, sex, indications for tamoxifen use, and systemic diseases associated with various macular conditions. Additionally, Cox proportional hazard models were used to determine the baseline clinical characteristics predictive of these macular conditions, with subsequent calculation of hazard ratios. Cumulative incidences of overall macular diseases, other maculopathy excluding common macular diseases, and macular edema were 26.4, 11.4, and 6.5%, respectively. The incidence of various macular conditions increased with age and the cumulative tamoxifen dose. Age, cumulative dose group, and liver diseases demonstrated significant associations with overall macular diseases and maculopathy excluding common macular diseases in multivariate logistic regression analyses (all P < 0.05). Furthermore, age emerged as significant predictive factors of maculopathy in Cox proportional hazard models. Tamoxifen-induced maculopathy poses a concern for prescribing physicians and ophthalmologists, and this study provides valuable insights into its risk and risk factors. This study may contribute to evidence-based guidelines for tamoxifen maculopathy screening, emphasizing the importance of considering age, cumulative dose, and liver diseases for recommendation on screening timing and frequency.

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Tamoxifen retinopathy: A comprehensive review

Cited by 4 publications

References 26 publications

Risk of Maculopathy in Tamoxifen Users: Drug Exposure and Risk Factors

Risk of Maculopathy in Tamoxifen Users: Drug Exposure and Risk Factors

Tamoxifen protects photoreceptors in the sodium iodate model

Drug exposure and risk factors of maculopathy in tamoxifen users

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