Screening of Oral Tamoxifen Ocular Toxicity in Breast Cancer Patients

Background Breast cancer is one of the leading cancer types among females worldwide. Prevalence of breast cancer is reported to be the second most common among women. Several treatment lines were prescribed in treatment of breast cancer besides surgical, radiological interventions. Tamoxifen is one of the medical treatments used in postsurgical prophylaxis of breast cancer. Various visual problems were reported with tamoxifen therapy. These include posterior subcapsular cataracts, color vision changes, optic neuritis, and intra-retinal crystals. Aim of the Work The aim of the work was to screen for ocular toxicity of tamoxifen used for treatment of breast cancer patients having no ophthalmic complains and treated with tamoxifen for at least 2 years with dose (20mg per day). Patients and Methods We included 50 female patients with breast cancer treated with Tamoxifen therapy for at least 2 years then we divided them into two groups regarding duration of tamoxifen intake from (2-4) years group and from (5-8) years group, all subjects underwent complete careful history taking and full ophthalmological examination, BCVA was measured using Snellen chart with conversion to log. MAR notation for statistical analysis. Results There was significant correlation between duration of tamoxifen intake and RPE mottling, no other significant correlations were detected, there was no significant difference in mean of BCVA, IOP, cup values, disc parameters, GCC thickness, RNFL zones between the two groups except for (inferior quadrant), macular thickness except in (superior quadrant), OCT layers thinning shows RNFL affection in (34%) of cases, GCC affection in (48%) of cases and macula affection in (64%) of cases, color vision defects was found in (12%) and electrophysiological test changes found in few cases. Conclusion Tamoxifen therapy causes minimal affection on the ocular structure and function, OCT layers thinning (34-64% of cases) preceed the clinical changes this highlights the importance of OCT examination in those patients to evaluate tamoxifen toxicity and further studies will be needed to evaluate reversibility of these changes after stoppage of therapy, main ocular complications associated with tamoxifen therapy were correlated to duration of treatment.