Retinal Central Vein Occlusion With Tamoxifen Therapy: A Case Report

Introduction/Background Ocular toxicity of tamoxifen can be corneal, neurological or retinal. The risk is low but can occurs in small doses. Indeed, a careful examination is recommended to look for it, specially since continued therapy may decrease reversibility chances. Methodology We report a case of a 46 years old woman with retinal central vein occlusion due to tamoxifen therapy. we did a systematic review of the litterature. Results We report a case of 46 years old woman with thyroiditis history, treated for invasive ductal carcinoma of the right breast. She underwent radical right mastectomy with axillary lymph node dissection. It was a luminal A SBR I Tumour. She underwent hormonotherapy by Tamoxifen and ovarian suppression by radiotherapy. After a follow-up of 13 months, she presented an ocular redness pain, blurring of vision and loss of eyesight. Funduscopic examination and fluorescein angiography showed a right retinal vein occlusion and an early stage of occlusion of the left one. She received a curative low-molecular-weight heparin. Thrombophilia research was negative, so tamoxifen was incriminated and stopped. Control funduscopic examination was performed and showed a repermeability of both retinal veins. Hormonotherapy was switched to aromatase inhibitor. However, the patient developed, despite cessation of the treatment, an irreversible right blindness. Conclusion Ocular side effects of tamoxifen are known since 1978 such as optical neuropathy, vein occlusion and most of all retinal effects. It can occur even for usual doses and can be potentiated by chorio-retinal and thromboembolic diseases. Treatment and outcome surveillance are non-codified, we must be careful because reversibility of the side effect depends on the earliness of treatment. Disclosure Nothing to disclose.