PDF(Pubmed)
Abstract：
(1) Background/Objectives: To investigate the nationwide screening practices and trends in tamoxifen retinal toxicity (tamoxifen retinopathy) in South Korea using national health insurance claims data. (2) Methods: A total of 43,848 patients who started tamoxifen therapy between 2015 and 2020 and had no prior ophthalmic diseases or other conditions requiring screening for retinopathy were included. The annual numbers of tamoxifen users and new initiators of tamoxifen therapy were assessed. The screening examinations were separated into baseline (first ophthalmic examination after tamoxifen administration) and subsequent monitoring examinations. The timing and modalities for the baseline and subsequent monitoring examinations performed between 2015 and 2021 were assessed in tamoxifen users. (3) Results: The annual number of tamoxifen users increased over the study period from 54,056 in 2015 to 81,720 in 2021. The number of patients who underwent ophthalmic examination after tamoxifen administration was 8961 (20.4%). Baseline screening was performed in 6.5% of patients within 1 year of use, and subsequent monitoring was performed in 27.8% of patients who underwent baseline screening. Funduscopy or fundus photography was performed most commonly for baseline screening and subsequent monitoring (99.0% and 98.6%, respectively), while optical coherence tomography was performed only in 21.9% and 29.6% of baseline and monitoring examinations, respectively. The average number of monitoring examinations per year was 0.68 ± 0.45. Although the annual percentage of patients receiving a baseline examination within 1 year gradually increased over time, the percentage of those with subsequent monitoring performed within 1 year was similar over the study period. (4) Conclusions: Our finding, appropriate screening in a small proportion of patients receiving tamoxifen, suggests the need to promote awareness among healthcare professionals and develop a standardized approach for screening for tamoxifen retinopathy.
摘要：
（1）背景/目的：使用国家健康保险索赔数据，调查韩国他莫昔芬视网膜毒性（他莫昔芬视网膜病变）的全国筛查实践和趋势。（2）方法：纳入2015年至2020年期间开始他莫昔芬治疗的43,848例患者，没有既往眼科疾病或其他需要筛查视网膜病变的疾病。评估了他莫昔芬使用者和他莫昔芬治疗新发起者的年度数量。筛选检查分为基线（他莫昔芬给药后的第一次眼科检查）和随后的监测检查。在他莫昔芬使用者中评估了2015年至2021年之间进行的基线和后续监测检查的时间和方式。（3）结果：在研究期间，他莫昔芬的年度用户数量从2015年的54,056人增加到2021年的81,720人。他莫昔芬给药后接受眼科检查的患者为8961例(20.4%)。在使用1年内，有6.5％的患者进行了基线筛查，随后对27.8%接受基线筛查的患者进行了监测.Funduscopy或眼底照相最常用于基线筛查和后续监测（99.0％和98.6％，分别)，而光学相干断层扫描仅在基线和监测检查的21.9%和29.6%中进行，分别。平均每年监测检查次数为0.68±0.45。尽管在一年内接受基线检查的患者的年度百分比随着时间的推移逐渐增加，在研究期间,在1年内进行后续监测的患者的百分比相似.(4)结论：我们的发现，在一小部分接受他莫昔芬的患者中进行适当的筛查，建议有必要提高医疗保健专业人员的认识，并开发一种标准化方法来筛查他莫昔芬视网膜病变。
