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RetinaJune 202011 citations

TAMOXIFEN-INDUCED CHORIORETINAL CHANGES: An Optical Coherence Tomography and Optical Coherence Tomography Angiography Study.

Crisóstomo Sara, Vieira Luísa, Cardigos Joana, Fernandes Diogo H, Luís Maria E, Nunes Susana, Morujão Inês, Anjos Rita, Flores Rita


AI Summary

Tamoxifen treatment causes subclinical retinal and choroidal thinning, suggesting early RPE and photoreceptor damage, highlighting the need for monitoring tamoxifen-induced ocular toxicity.

Abstract

Purpose

To study structural chorioretinal changes in tamoxifen-treated patients.

Methods

Cross-sectional case-control study comparing structural chorioretinal aspects in tamoxifen-treated patients and healthy controls. Enhanced depth spectral domain optic coherence tomography with choroidal binarization and optic coherence tomography angiography were performed. Individual retinal layer thickness and chorioretinal vascular components were compared. Subgroup analysis regarding history of chemotherapy was performed.

Results

Two hundred eyes of 100 TAM-treated patients (Group 1) and 80 eyes of 40 healthy controls (Group 2) were included. Of the 200 spectral domain optic coherence tomography scans from patients, 2 showed structural changes attributable to tamoxifen. Group 1 showed significantly lower values in choroidal parameters and in total retinal, ganglion cell layer, inner plexiform layer, outer nuclear layer, and retinal pigment epithelial thicknesses as well as an increased thickness in the outer plexiform layer. The subgroup not submitted to chemotherapy maintained significant reductions in total retinal thickness, ganglion cell layer, retinal pigment epithelium, outer nuclear layer, outer retinal layer, choroidal parameters, as well as an increased thickness in the outer plexiform layer, in comparison with Group 2.

Conclusion

Subclinical structural retinal changes could indicate early retinal pigment epithelial and photoreceptor damage. The new finding of choroidal thinning could point toward another important pathophysiologic process in tamoxifen-induced toxicity.


MeSH Terms

Case-Control StudiesChoroidCross-Sectional StudiesEstrogen AntagonistsFemaleFluorescein AngiographyFundus OculiHumansMaleMiddle AgedRetinal DiseasesRetinal Ganglion CellsTamoxifenTomography, Optical Coherence

Key Concepts5

Tamoxifen-treated patients (Group 1, 200 eyes of 100 patients) showed significantly lower values in choroidal parameters and in total retinal, ganglion cell layer, inner plexiform layer, outer nuclear layer, and retinal pigment epithelial thicknesses as well as an increased thickness in the outer plexiform layer compared to healthy controls (Group 2, 80 eyes of 40 controls).

MechanismCross-sectionalCross-sectional case-control studyn=200 eyes of 100 tamoxifen-treated pat…Ch5

In a subgroup of tamoxifen-treated patients not submitted to chemotherapy, significant reductions were maintained in total retinal thickness, ganglion cell layer, retinal pigment epithelium, outer nuclear layer, outer retinal layer, and choroidal parameters, along with an increased thickness in the outer plexiform layer, when compared to healthy controls.

MechanismCross-sectionalCross-sectional case-control study with subgroup analysisn=Subgroup of tamoxifen-treated patient…Ch5

Subclinical structural retinal changes observed in tamoxifen-treated patients could indicate early retinal pigment epithelial and photoreceptor damage.

PrognosisCross-sectionalCross-sectional case-control studyn=200 eyes of 100 tamoxifen-treated pat…Ch5

The new finding of choroidal thinning in tamoxifen-treated patients could point toward another important pathophysiologic process in tamoxifen-induced toxicity.

MechanismCross-sectionalCross-sectional case-control studyn=200 eyes of 100 tamoxifen-treated pat…Ch5

Two out of 200 spectral domain optic coherence tomography scans from tamoxifen-treated patients (Group 1, 200 eyes of 100 patients) showed structural changes attributable to tamoxifen.

DiagnosisCross-sectionalCross-sectional case-control studyn=200 eyes of 100 tamoxifen-treated pat…Ch5

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