Abstract
Tamoxifen, an effective treatment of breast cancer, has been shown to cause ocular toxic effects. The purpose of this study was to determine retinal toxicity by full-field and focal electroretinograms (ERGs) in patients treated with tamoxifen. Full-field and focal ERGs were obtained from three groups: Tamoxifen—14 females (47–72 years, mean 58.3 ± 9.1) with normal fundus, treated with tamoxifen from 2 to 37 months; No Treatment—10 females (39–65 years, mean 50.1 ± 8.7) with previous breast cancer diagnosis and before tamoxifen treatment; Control—13 normal female volunteers (41–81 years, mean 52.7 ± 12.1). Peak-to-peak amplitude and b-wave implicit time were measured and statistically analyzed. Mean peak-to-peak amplitudes and implicit time from full-field and focal ERGs were comparable for the three different groups. Low-dosage tamoxifen showed no retinotoxic effect assessed by full-field and focal ERG in this small group of women with breast cancer.
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Gordon NH, Silverman P, Lasheen W, Meinert J, Siminoff LA (2007) Thirty-year follow-up of chemo-hormonal therapy in node-positive breast cancer. Breast Cancer Res Treat 102:301–312
Early Breast Cancer Trialists’ Collaborative Group (1998) Polychemotherapy for early breast cancer: an overview of the randomized trials. Lancet 352:930–942
Early Breast Cancer Trialists’ Collaborative Group (1998) Tamoxifen for early breast cancer: an overview of the randomized trials. Lancet 351:1451–1467
Fisher B, Costantino J, Redmond C, Poisson R, Bowman D, Couture J, Dimitrov NV, Wolmark N, Wickerham DL, Fisher ER, Margolese R, Robidoux A, Shibata H, Terz J, Paterson AHG, Feldman MI, Farrar W, Evans J, Lickley L, Ketner M, Abramson N, Allegra JC, Beazley R, Berry J, Boatman KK, Carmichael D, Cruz AB Jr, Davies R, Deckers P, Desser R, Reese M, Economou S, Elias G, Feldman M, Foster RS, Frazier TG, Glass AG, Jochimsen P, Jubelirer S, Kardinal CG, Keyserlingk JR, Lerner HJ, Levick SN, Mahoney L, Mowry P, Nicola M, Oishi R, Pasquale D, Perrault D, Peters G, Poisson R, Pugh R, Robert N, Spector J, Sponzo R, Sterchi JM, Sutherland CM, Thiessen AR, Thirlwell M, Welling R, Wold H, Wozniak T (1989) A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumor. N Engl J Med 320:479–484
Jordan VC (1995) Tamoxifen for breast cancer prevention. Proc Soc Exp Biol Med 208:144–149
Powles TJ (1997) Efficacy of tamoxifen as treatment of breast cancer. Semin Oncol 24(Suppl 1):SI48–SI54
Meier CR, Jick H (1998) Tamoxifen and risk of idiopathic venous thromboembolism. Br J Clin Pharmacol 45:608–612
Osborne CK (1998) Tamoxifen in the treatment of breast cancer. N Engl J Med 339:1609–1618
Kaiser-Kupfer MI, Lippman ME (1978) Tamoxifen retinopathy. Cancer Treat Rep 62:315–320
Kaiser-Kupfer MI, Kupfer C, Rodrigues M (1981) Tamoxifen retinopathy: a clinicopathologic report. Ophthalmology 88:89–93
McKeown CA, Swartz M, Blom J, Maggiano JM (1981) Tamoxifen retinopathy. Br J Ophthalmol 65:177–179
Beck M, Mills PV (1979) Ocular assessment of patients treated with tamoxifen. Cancer Treat Rep 63:1833–1834
Pavlidis NA, Petris C, Briassoulis E, Klouvas G, Psilas C, Rempapis J, Petroutsos G (1992) Clear evidence that long-term, low-dose tamoxifen treatment can induce ocular toxicity. Cancer 69:2961–2964
Bernstein PS, DellaCroce JT (2007) Diagnostic & therapeutic challenges. Tamoxifen toxicity. Retina 27:982–988
Cronin BG, Lekich CK, Bourke RD (2005) Tamoxifen therapy conveys increased risk of developing a macular hole. Int Ophthalmol 26:101–105
Heier JS, Dragoo RA, Enzenauer RW, Waterhouse WJ (1994) Screening for ocular toxicity in asymptomatic patients treated with tamoxifen. Am J Ophthalmol 117:772–775
Tang R, Shields J, Schiffman J, Li H, Locher D, Hampton J, Prager T, Pardo G (1997) Retinal changes associated with tamoxifen treatment for breast cancer. Eye 11:295–297
Noureddin BN, Seoud M, Bashshur Z, Salem Z, Shamseddin A, Khalil A (1999) Ocular toxicity in low-dose tamoxifen: a prospective study. Eye 13:729–733
Gianni L, Panzini I, Li S, Gelber RD, Collins J, Holmberg SB, Crivellari D, Castiglione-Gertsch M, Goldhirsch A, Coates AS, Ravaioli A, International Breast Cancer Study Group (IBCSG) (2006) Ocular toxicity during adjuvant chemoendocrine therapy for early breast cancer: results from International Breast Cancer Study Group trials. Cancer 106:505–513
Salomão SR, Watanabe SE, Berezovsky A, Motono M (2007) Multifocal electroretinography, color discrimination and ocular toxicity in tamoxifen use. Curr Eye Res 32:345–352
Beck M, Mills PV (1979) Ocular assessment of patients treated with tamoxifen. Cancer Treat Rep 63:1833–1834
Longstaff S, Sigurdsson H, O′Keeffe M, Ogston S, Preece P (1989) A controlled study of the ocular effects of tamoxifen in conventional dosage in the treatment of breast carcinoma. Eur J Cancer Clin Oncol 25:1805–1808
Easterbrook M (1988) Ocular effects and safety of antimalarial agents. Am J Med 14:23–29
Zrenner E (2006) Drug side effects and toxicology of the visual system. In: Heckenlively JR (ed) Principles and practice of clinical electrophysiology of vision, 2nd edn. Cambridge, London, pp 655–662
Kuchenbecker J, Pump-Schmidt C, Olbricht S, Weise W, Behrens-Baumann W (2001) Electrophysiological studies in breast carcinoma patients with tamoxifen retinopathy. Ophthalmologe 98:81–85
Ritter C, Renner AB, Wachtlin J, Bechrakis NE, Krause L (2008) Tamoxifen retinopathy: a case series of clinical and functional data. Ophthalmologe 105:544–549
Gerner EW (1989) Ocular toxicity of tamoxifen. Ann Ophthalmol 21:420–423
Bentley CR, Davies G, Aclimandos WA (1992) Tamoxifen retinopathy: a rare but serious complication. BMJ 304:495–496
Berezovsky A, Moraes NS, Nusinowitz S, Salomão SR (2003) Standard full-field electroretinography in healthy preterm infants. Doc Ophthalmol 107:243–249
Engelke M, Tykhonova S, Zorn-Kruppa M, Diehl H (2002) Tamoxifen induces changes in the lipid composition of the retinal pigment epithelium cell line D407. Pharmacol Toxicol 91:13–21
Toimela T, Tähti H, Salminen L (1995) Retinal pigment epithelium cell culture as a model for evaluation of the toxicity of tamoxifen and chloroquine. Ophthalmic Res 27:150–153
Gualino V, Cohen SY, Delyfer MN, Sahel JA, Gaudric A (2005) Optical coherence tomography findings in tamoxifen retinopathy. Am J Ophtahlmol 140:757–758
Eisner A, Austin DF, Samples JR (2004) Short wavelength automated perimetry and tamoxifen use. Br J Ophthalmol 88:125–130
Acknowledgments
This work is supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) grant # 01/03364-6 to S.R. Salomão. Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Brasília, Brasil) pre-doctoral scholarship to S.E.S. Watanabe.
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Watanabe, S.E.S., Berezovsky, A., Motono, M. et al. Retinal function in patients treated with tamoxifen. Doc Ophthalmol 120, 137–143 (2010). https://doi.org/10.1007/s10633-009-9203-8
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DOI: https://doi.org/10.1007/s10633-009-9203-8