Heier J S, Dragoo R A, Enzenauer R W, Waterhouse W J
Ophthalmology Service, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.
Am J Ophthalmol. 1994 Jun 15;117(6):772-5. doi: 10.1016/s0002-9394(14)70321-6.
Tamoxifen is an antiestrogen drug used in the treatment of patients with breast cancer that is being studied for use in patients at high risk for developing breast cancer. Case reports have documented ocular toxicity caused by tamoxifen in patients with visual symptoms. We attempted to determine the prevalence of ocular toxicity in visually asymptomatic tamoxifen-treated patients. We performed extensive ocular examinations on 135 visually asymptomatic tamoxifen-treated patients. Two patients (1.5%) had intraretinal refractile crystals consistent with tamoxifen retinopathy. Both patients were without visual symptoms or visual loss. Corneal crystals, macular edema, and optic nerve changes were absent. The cumulative tamoxifen doses of these two patients were 10.9 and 21.9 g, respectively. For the 135 patients studied, the mean cumulative dose was 17.2 g, with a standard deviation of 13.0. We do not believe the relatively uncommon finding of tamoxifen-related ocular toxicity merits special screening for such disease.
他莫昔芬是一种用于治疗乳腺癌患者的抗雌激素药物，目前正在研究用于乳腺癌高危患者。病例报告记录了他莫昔芬在有视觉症状的患者中引起的眼部毒性。我们试图确定在无症状的接受他莫昔芬治疗的患者中眼部毒性的发生率。我们对135名无症状的接受他莫昔芬治疗的患者进行了全面的眼部检查。两名患者（1.5%）有与他莫昔芬视网膜病变一致的视网膜内折射晶体。两名患者均无视觉症状或视力丧失。角膜晶体、黄斑水肿和视神经改变均未出现。这两名患者的他莫昔芬累积剂量分别为10.9克和21.9克。对于所研究的135名患者，平均累积剂量为17.2克，标准差为13.0。我们认为，他莫昔芬相关眼部毒性这一相对不常见的发现不值得对此类疾病进行特殊筛查。
