The optical imaging and clinical features of tamoxifen associated macular hole: A case report and review of the literatures.

We report a case of tamoxifen associated macular hole with typical optical imaging and clinical features. A 53-year-old woman came to our department for gradual decrease of vision acuity in both eyes for 3 months, after 30 months low-dosage-tamoxifen treatment as adjuvant treatment for invasive ductal breast carcinoma. Her best corrected visual acuity (BCVA) was 0.4 in the right eye and 0.12 in the left eye. Dilated fundus examination showed macular multiple, fine, crystalline deposits and small white points in retina of both eyes. Blue light fundus autofluorescence showed fovea local hyper-fluorescence. Fluorescein angiography showed fovea local hyper-fluorescence in early stage and stain in late stage. Optical coherence tomography was performed. There were many point hyper-reflections in posterior retina in both eyes with fovea local posterior vitreous body detachment. Inner fovea mismatching, intact outer limiting membrane, bluer interdigitation zone, ruptured Ellipsoid zone and granular change of outer segments of photoreceptors were found in right eye. Blured interdigitation zone and granular change of outer segments of photoreceptors were also found in left eye with macular hole. Multifocal electroretinogram revealed reduced response in paracentral and pericentral area in both the eyes. And we reviewed the diagnosis and treatment of the disease.