Tamoxifen induced maculopathy presenting like macular telangiectasia type 2 in a patient with breast cancer

J Oncol Pharm Pract. 2023 Mar;29(2):489-492. doi: 10.1177/10781552221110472. Epub 2022 Jun 22.

Abstract

Introduction: Drug-induced crystalline maculopathy has been reported secondary to tamoxifen use for breast cancer treatment. It could be misdiagnosed as macular telangiectasia type 2 (MacTel type 2).

Case report: A 56-year-old woman with a history of diabetes mellitus and breast cancer was referred to our clinic with painless, bilateral, gradual onset of central vision loss for several months. The fundus examination showed the macular pigmentary change in both eyes and a few refractile crystalline deposits in the parafoveal area in the left eye. However, the rest of the retina was normal in both eyes.

Management and outcome: With the diagnosis of tamoxifen-induced maculopathy, the drug was discontinued and supplementary treatment was started.

Discussion: In this report, patient medical and drug history was an important and powerful measure. Due to the side effects of long-term use of tamoxifen, we need further studies on the need for retinal screening in these patients.

Keywords: Tamoxifen maculopathy; breast cancer; case report; crystalline retinopathy; macular telangiectasia.

Publication types

  • Case Reports

MeSH terms

  • Breast Neoplasms* / drug therapy
  • Diabetes Mellitus, Type 2* / chemically induced
  • Diabetes Mellitus, Type 2* / drug therapy
  • Female
  • Fluorescein Angiography
  • Humans
  • Macular Degeneration* / chemically induced
  • Macular Degeneration* / drug therapy
  • Middle Aged
  • Retinal Telangiectasis* / chemically induced
  • Retinal Telangiectasis* / diagnosis
  • Retinal Telangiectasis* / drug therapy
  • Tamoxifen / adverse effects
  • Tomography, Optical Coherence

Substances

  • Tamoxifen

Supplementary concepts

  • Idiopathic Juxtafoveal Retinal Telangiectasia