Rijal Roshija Khanal, Nakhwa Chinmay, Sindal Manavi D
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, 605007 India.
Nepal J Ophthalmol. 2014 Jul-Dec;6(2):227-9. doi: 10.3126/nepjoph.v6i2.11713.
Tamoxifen citrate is an anti-estrogen agent used in the treatment of breast carcinoma. Crystalline maculopathy is a rare complication of tamoxifen therapy. The clinical picture resembles that of idiopathic macular telangiectasia (IMT) Type 2, which is a more common clinical entity.
To report a case of crystalline maculopathy secondary to tamoxifen and highlight the importance of the medical history and investigations in differentiating it from IMT Type 2.
A diabetic female with a past history of breast carcinoma treated with tamoxifen came to the hospital for a routine eye check-up. Crystalline deposits were seen in the parafoveal region in both the eyes.The spectral domain optical coherence tomography (SD-OCT) showed foveal cysts in the inner retinal layer and fundus autofluorescence (FAF) and fundus fluorescein angiography (FFA) were within normal limits.
While tamoxifen maculopathy is reversible on stopping the therapy, IMT needs a long-term follow-up to monitor the potential risk of loss of vision due to choroidal neovascularization, hence necessitating the distinction between these two different clinical entities.
枸橼酸他莫昔芬是一种用于治疗乳腺癌的抗雌激素药物。结晶性黄斑病变是他莫昔芬治疗的一种罕见并发症。其临床表现类似于2型特发性黄斑毛细血管扩张症（IMT），后者是一种更常见的临床病症。
报告一例由他莫昔芬引起的结晶性黄斑病变病例，并强调病史和检查在将其与2型IMT相鉴别中的重要性。
一名有乳腺癌病史且曾接受他莫昔芬治疗的糖尿病女性前来医院进行常规眼部检查。双眼黄斑旁区域均可见结晶样沉积物。频域光学相干断层扫描（SD-OCT）显示视网膜内层有黄斑囊肿，眼底自发荧光（FAF）和眼底荧光血管造影（FFA）均在正常范围内。
虽然他莫昔芬所致黄斑病变在停药后可逆转，但IMT需要长期随访以监测因脉络膜新生血管形成导致视力丧失的潜在风险，因此有必要区分这两种不同的临床病症。
