Foveal cone loss in tamoxifen maculopathy: a case report
Abstract Background Tamoxifen is used in low dose concentrations (20–40 mg per day) as a therapy for breast cancer but is known to have ocular side effects. In this case report, the foveal cone integrity in a tamoxifen-treated patient who complained of a small central scotoma in the left eye while r...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-023-04199-z |
| _version_ | 1797559458978594816 |
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| author | Nathan Doble Elaine M. Wells-Gray Michael Wells Stacey S. Choi |
| author_facet | Nathan Doble Elaine M. Wells-Gray Michael Wells Stacey S. Choi |
| author_sort | Nathan Doble |
| collection | DOAJ |
| description | Abstract Background Tamoxifen is used in low dose concentrations (20–40 mg per day) as a therapy for breast cancer but is known to have ocular side effects. In this case report, the foveal cone integrity in a tamoxifen-treated patient who complained of a small central scotoma in the left eye while reading was examined using high resolution adaptive optics imaging. Case presentation Both eyes of a 54-year-old Caucasian, non-hispanic female who had been treated with tamoxifen for 1.5 years were examined using various imaging modalities including fundus photography, fundus autofluorescence, fluorescein angiography, spectral-domain optical coherence tomography, and adaptive optics scanning laser ophthalmoscopy. Clinical spectral-domain optical coherence tomography showed a very small disruption to the photoreceptor layer at the fovea in the left eye only. However, adaptive optics scanning laser ophthalmoscopy imaging revealed foveal cone loss in both eyes, but to a lesser extent in the right eye. Inner retinal changes were not observed in either eye. Conclusion The area of cone loss was similar in size to a single newsprint letter when projected onto the retina, matching the patient’s description of a scotoma in the left eye. Given the isolated loss of foveal cone photoreceptors with the absence of previously reported inner retinal and vascular changes, our results may indicate the earliest retinal changes associated with tamoxifen retinopathy. |
| first_indexed | 2024-03-10T17:45:44Z |
| format | Article |
| id | doaj.art-3a49bac2e97142d8b38a40a6106bf9f0 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-10T17:45:44Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-3a49bac2e97142d8b38a40a6106bf9f02023-11-20T09:31:35ZengBMCJournal of Medical Case Reports1752-19472023-11-011711510.1186/s13256-023-04199-zFoveal cone loss in tamoxifen maculopathy: a case reportNathan Doble0Elaine M. Wells-Gray1Michael Wells2Stacey S. Choi3College of Optometry, The Ohio State UniversityCollege of Optometry, The Ohio State UniversityDepartment of Ophthalmology and Vision Science, Havener Eye Institute, The Ohio State UniversityCollege of Optometry, The Ohio State UniversityAbstract Background Tamoxifen is used in low dose concentrations (20–40 mg per day) as a therapy for breast cancer but is known to have ocular side effects. In this case report, the foveal cone integrity in a tamoxifen-treated patient who complained of a small central scotoma in the left eye while reading was examined using high resolution adaptive optics imaging. Case presentation Both eyes of a 54-year-old Caucasian, non-hispanic female who had been treated with tamoxifen for 1.5 years were examined using various imaging modalities including fundus photography, fundus autofluorescence, fluorescein angiography, spectral-domain optical coherence tomography, and adaptive optics scanning laser ophthalmoscopy. Clinical spectral-domain optical coherence tomography showed a very small disruption to the photoreceptor layer at the fovea in the left eye only. However, adaptive optics scanning laser ophthalmoscopy imaging revealed foveal cone loss in both eyes, but to a lesser extent in the right eye. Inner retinal changes were not observed in either eye. Conclusion The area of cone loss was similar in size to a single newsprint letter when projected onto the retina, matching the patient’s description of a scotoma in the left eye. Given the isolated loss of foveal cone photoreceptors with the absence of previously reported inner retinal and vascular changes, our results may indicate the earliest retinal changes associated with tamoxifen retinopathy.https://doi.org/10.1186/s13256-023-04199-zAdaptive opticsCone photoreceptorsImagingRetinaScanning laser ophthalmoscopyTamoxifen maculopathy |
| spellingShingle | Nathan Doble Elaine M. Wells-Gray Michael Wells Stacey S. Choi Foveal cone loss in tamoxifen maculopathy: a case report Journal of Medical Case Reports Adaptive optics Cone photoreceptors Imaging Retina Scanning laser ophthalmoscopy Tamoxifen maculopathy |
| title | Foveal cone loss in tamoxifen maculopathy: a case report |
| title_full | Foveal cone loss in tamoxifen maculopathy: a case report |
| title_fullStr | Foveal cone loss in tamoxifen maculopathy: a case report |
| title_full_unstemmed | Foveal cone loss in tamoxifen maculopathy: a case report |
| title_short | Foveal cone loss in tamoxifen maculopathy: a case report |
| title_sort | foveal cone loss in tamoxifen maculopathy a case report |
| topic | Adaptive optics Cone photoreceptors Imaging Retina Scanning laser ophthalmoscopy Tamoxifen maculopathy |
| url | https://doi.org/10.1186/s13256-023-04199-z |
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