Eisner A, Austin D F, Samples J R
Neurological Sciences Institute, Oregon Health & Science University, West Campus, 505 NW 185th Avenue, Beaverton, OR 97006, USA.
Br J Ophthalmol. 2004 Jan;88(1):125-30. doi: 10.1136/bjo.88.1.125.
BACKGROUND/AIMS: Oestrogen receptors (ORs) have been reported to be present in the retina, and the selective oestrogen receptor modulator tamoxifen has been reported to affect colour vision. This study aimed, therefore, to determine whether standard doses of tamoxifen affect visual sensitivities mediated via short wavelength sensitive (SWS) cones.
Two types of visual fields were measured for middle aged women who were being treated with 20 mg of tamoxifen daily as adjuvant therapy for early stage breast cancer. Visual fields were measured using short wavelength automated perimetry (SWAP) and frequency doubling perimetry (FDP). For SWAP, 24-2 visual fields were analysed. No subjects had tamoxifen retinopathy or other eye disease. For each type of visual field, mean deviations (MDs) were assessed as a function of the duration of tamoxifen use, using a cross sectional design. In addition, the difference between the two types of MDs was computed after standardisation of each type of MD separately, and this difference itself was evaluated as a function of the duration of tamoxifen use. Duration dependent changes for SWAP were further evaluated as a function of eccentricity within the visual field, and the visual field data were compared with foveal data obtained psychophysically.
SWAP sensitivities depended on the duration of tamoxifen use. Subjects who used tamoxifen for about 2 years or less were significantly more likely than subjects who had longer use to have high MDs. The difference between the standardised SWAP and FDP MDs likewise was significantly related to the duration of use, whereas duration of use effects for FDP itself were reduced or absent. Although the duration of use effect observed for SWAP was strongest in the peripheral portion of the visual field, there was evidence of changes in SWS cone mediated vision even at the fovea.
Standard dosages of tamoxifen can affect SWAP visual fields. The effects of tamoxifen are not equivalent for SWAP and FDP, indicating that tamoxifen affects some types of visual pathways preferentially or selectively. SWS cone pathways, in particular, are affected. SWAP appears able to reveal effects of tamoxifen occurring years before completion of the standard 5 year regimen of use.
背景/目的：有报道称视网膜中存在雌激素受体（ORs），且有报道称选择性雌激素受体调节剂他莫昔芬会影响色觉。因此，本研究旨在确定标准剂量的他莫昔芬是否会影响经由短波长敏感（SWS）视锥细胞介导的视觉敏感度。
对每日接受20mg他莫昔芬作为早期乳腺癌辅助治疗的中年女性测量两种类型的视野。使用短波长自动视野计（SWAP）和倍频视野计（FDP）测量视野。对于SWAP，分析了24-2视野。没有受试者患有他莫昔芬视网膜病变或其他眼部疾病。对于每种类型的视野，采用横断面设计，将平均偏差（MDs）评估为他莫昔芬使用时长的函数。此外，在分别对每种类型的MD进行标准化后，计算两种类型MD之间的差异，并将该差异本身评估为他莫昔芬使用时长的函数。SWAP的时长依赖性变化进一步根据视野内的偏心度进行评估，并将视野数据与通过心理物理学获得的中央凹数据进行比较。
SWAP敏感度取决于他莫昔芬的使用时长。使用他莫昔芬约2年或更短时间的受试者比使用时间更长的受试者更有可能出现高MDs。标准化的SWAP和FDP MDs之间的差异同样与使用时长显著相关，而FDP本身的使用时长效应减弱或不存在。尽管在视野的周边部分观察到的SWAP使用时长效应最强，但即使在中央凹也有SWS视锥细胞介导的视觉变化的证据。
标准剂量的他莫昔芬可影响SWAP视野。他莫昔芬对SWAP和FDP的影响并不等同，表明他莫昔芬优先或选择性地影响某些类型的视觉通路。特别是SWS视锥细胞通路受到影响。SWAP似乎能够揭示在标准的5年使用疗程结束前数年发生的他莫昔芬的影响。
