PDF(Pubmed)
Abstract：
BACKGROUND: Tamoxifen is used in low dose concentrations (20-40 mg per day) as a therapy for breast cancer but is known to have ocular side effects. In this case report, the foveal cone integrity in a tamoxifen-treated patient who complained of a small central scotoma in the left eye while reading was examined using high resolution adaptive optics imaging.
METHODS: Both eyes of a 54-year-old Caucasian, non-hispanic female who had been treated with tamoxifen for 1.5 years were examined using various imaging modalities including fundus photography, fundus autofluorescence, fluorescein angiography, spectral-domain optical coherence tomography, and adaptive optics scanning laser ophthalmoscopy. Clinical spectral-domain optical coherence tomography showed a very small disruption to the photoreceptor layer at the fovea in the left eye only. However, adaptive optics scanning laser ophthalmoscopy imaging revealed foveal cone loss in both eyes, but to a lesser extent in the right eye. Inner retinal changes were not observed in either eye.
CONCLUSIONS: The area of cone loss was similar in size to a single newsprint letter when projected onto the retina, matching the patient\'s description of a scotoma in the left eye. Given the isolated loss of foveal cone photoreceptors with the absence of previously reported inner retinal and vascular changes, our results may indicate the earliest retinal changes associated with tamoxifen retinopathy.
METHODS: Both eyes of a 54-year-old Caucasian, non-hispanic female who had been treated with tamoxifen for 1.5 years were examined using various imaging modalities including fundus photography, fundus autofluorescence, fluorescein angiography, spectral-domain optical coherence tomography, and adaptive optics scanning laser ophthalmoscopy. Clinical spectral-domain optical coherence tomography showed a very small disruption to the photoreceptor layer at the fovea in the left eye only. However, adaptive optics scanning laser ophthalmoscopy imaging revealed foveal cone loss in both eyes, but to a lesser extent in the right eye. Inner retinal changes were not observed in either eye.
CONCLUSIONS: The area of cone loss was similar in size to a single newsprint letter when projected onto the retina, matching the patient\'s description of a scotoma in the left eye. Given the isolated loss of foveal cone photoreceptors with the absence of previously reported inner retinal and vascular changes, our results may indicate the earliest retinal changes associated with tamoxifen retinopathy.
摘要：
背景：他莫昔芬以低剂量浓度（每天20-40mg）用作乳腺癌的疗法，但已知具有眼部副作用。在这个案例报告中,1例接受他莫昔芬治疗的患者在阅读时主诉左眼中心性暗点小,我们使用高分辨率自适应光学成像检查了该患者的中心凹锥体完整性.
方法：54岁白种人的双眼，接受他莫昔芬治疗1.5年的非西班牙裔女性使用各种成像方式进行检查，包括眼底照相，眼底自发荧光，荧光素血管造影,谱域光学相干层析成像,和自适应光学扫描激光检眼镜。临床谱域光学相干断层扫描显示，仅左眼中央凹的感光层受到很小的破坏。然而,自适应光学扫描激光检眼镜成像显示双眼中央凹锥体丢失，但在右眼的程度较小。两眼均未观察到内部视网膜变化。
结论：当投射到视网膜上时，视锥丢失的面积与单个新闻纸字母的大小相似，匹配患者对左眼暗点的描述。鉴于中央凹锥体光感受器的单独丢失，没有先前报道的内部视网膜和血管变化，我们的结果可能表明最早的视网膜改变与他莫昔芬视网膜病变相关.
方法：54岁白种人的双眼，接受他莫昔芬治疗1.5年的非西班牙裔女性使用各种成像方式进行检查，包括眼底照相，眼底自发荧光，荧光素血管造影,谱域光学相干层析成像,和自适应光学扫描激光检眼镜。临床谱域光学相干断层扫描显示，仅左眼中央凹的感光层受到很小的破坏。然而,自适应光学扫描激光检眼镜成像显示双眼中央凹锥体丢失，但在右眼的程度较小。两眼均未观察到内部视网膜变化。
结论：当投射到视网膜上时，视锥丢失的面积与单个新闻纸字母的大小相似，匹配患者对左眼暗点的描述。鉴于中央凹锥体光感受器的单独丢失，没有先前报道的内部视网膜和血管变化，我们的结果可能表明最早的视网膜改变与他莫昔芬视网膜病变相关.
