Long-term tamoxifen citrate use and potential ocular toxicity - 09/09/11

Doi : 10.1016/S0002-9394(99)80190-1

Michael B. Gorin, MD, PhD ^a,^⁎ , Richard Day, PhD ^b, Joseph P. Costantino, DrPH ^b, Bernard Fisher, MD ^c, Carol K. Redmond, ScD ^b, Lawrence Wickerham, MD ^c, Julius E.S. Gomolin, MD ^d, Richard G. Margolese, MD, FRCS(C) ^e, Mathen K. Mathen, MD ^f, David M. Bowman, MD ^f, David Kaufmann, DO ^g, Nikolay V. Dimitrov, MD ^g, Lawrence J. Singerman, MD ^h, Richard Bornstein, MD ⁱ, Norman Wolmark, MD ^c
^a From the Departments of Ophthalmology and Human Genetics, School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
^b From the Department of Biostatistics, Graduate School of Public Health, the University of Pittsburgh, Pittsburgh, Pennsylvania, USA
^c From the Division of Surgical Oncology, Allegheny University, Pittsburgh, Pennsylvania, USA
^d From the Department of Ophthalmology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
^e From the Department of Oncology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
^f From the Manitoba Cancer Treatment and Research Foundation/Misericordia General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada
^g From the Department of Internal Medicine, Michigan State University, East Lansing, Michigan, USA
^h From the Retina Associates of Cleveland, the Retinal Institute, Mount Sinai Medical Center, and the Department of Ophthalmology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
ⁱ From the Department of Medicine, Mount Sinai Medical Center, Cleveland, Ohio, USA

^**Reprint requests to Michael B. Gorin, MD, PhD, Department of Ophthalmology, University of Pittsburgh, 203 Lothrop St, Pittsburgh, PA 15213; fax: (412) 647-5880.

Abstract

Purpose

To estimate the prevalence of abnormalities in visual function and ocular structures associated with the long-term use of tamoxifen citrate.

Methods

A single-masked, cross-sectional study involving multiple community and institutional ophthalmologic departments was conducted with a volunteer sample of 303 women with breast cancer currently taking part in a randomized clinical trial to determine the efficacy of tamoxifen (20 mg/day) in preventing recurrences. Participants included women who had never been on drug (n = 85); women who had taken tamoxifen for an average of 4.8 years, then been off the drug for an average of 2.7 years (n = 140); and women who had been on tamoxifen continuously for an average of 7.8 years (n = 78). Women were evaluated by questionnaire, psychophysical testing, and clinical examination to determine any abnormalities in visual function and the comparative prevalences of corneal, lens, retinal, and optic nerve pathology.

Results

There were no cases of vision-threatening ocular toxicity among the tamoxifen-treated participants. Compared with nontreated participants, the tamoxifen-treated women had no differences in the activities of daily vision, visual acuity measurements, or other tests of visual function except for color screening. Intraretinal crystals (odds ratio [OR] = 3.58, P =.178) and posterior subcapsular opacities (OR = 4.03, P =.034) were more frequent in the tamoxifen-treated group.

Conclusions

Women should have a thorough baseline ophthalmic evaluation within the first year of initiating tamoxifen therapy and receive appropriate follow-up evaluations.

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*	This study was funded by grant U10CA37377 from the National Institutes of Health, National Cancer Institute, Bethesda, Maryland.

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Vol 125 - N° 4

P. 493-501 - avril 1998 Retour au numéro

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Long-term tamoxifen citrate use and potential ocular toxicity - 09/09/11

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