Tamoxifen ocular side effects

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    Tamoxifen ocular side effects


    Tamoxifen is a drug given to women who have had breast cancer, to help keep the cancer from coming back. It works by preventing estrogen from binding to breast-cancer cells; this blocking discourages the cells' growth. S., the drug is prescribed, after surgery, radiation treatment, and chemotherapy, to nearly all women with invasive breast cancer if their cancer is sensitive to estrogen. (About 75 percent of the 300,000 new breast-cancer cases each year are estrogen-sensitive). At present, the usual dose of tamoxifen for women with early-stage cancer is 20 mg per day, taken for five years. This means that over a million American women are on tamoxifen at any given time. New studies show that more lives might be saved if it is taken for ten years, so even more women will be taking the drug in the future. Tamoxifen is also sometimes prescribed preventatively for women at very high risk of breast cancer, for example, those carrying a BRCA mutation. The trouble with tamoxifen is that the drug acts on other tissues in addition to breast cancer. A 32-year-old Hispanic female with infiltrating ductal carcinoma of the left breast (T2N1M0, triple-positive), status post chemotherapy and bilateral mastectomy, presented with complaint of a floater and decreased central vision of the right eye (OD). Symptoms began three weeks after initiating tamoxifen and five months after the last cycle of chemotherapy and dexamethasone. Clinical examination and multimodal imaging revealed subretinal fluid (SRF) and pigment epithelial detachment (PED) suggestive of CSCR. After one month of monitoring, VA improved to 20/20; there was SRF resolution, small PED, and focal ellipsoid zone (EZ) band loss. Two weeks later, after undergoing surgery and starting a topical steroid, she returned with count fingers (CF) VA and large SRF OD. Steroid cessation improved SRF after one month, but VA was unchanged. Tamoxifen was discontinued, and VA improved to 20/100 with near-complete resolution of SRF at three weeks, and significant reduction in choroidal thickness at two months. At final follow-up, VA was 20/200, and there was focal EZ band loss sub-foveally, minimal SRF, and small PED.

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    Roughly one in every 15 tamoxifen users of five years or more will suffer from tamoxifen retinopathy the deterioration of the retina of the eye will stop after stopping tamoxifen. However, a full recovery of visual function is not expected. Other ocular side effects include inflammation of the optic nerve. Apr 12, 2015. Systemic side effects have been reported less commonly in comparison to tamoxifen and ocular toxicity has not been associated with the. The good news about the ocular side effects of tamoxifen is that if the drug is discontinued or the dosage reduced, ocular toxicities such as macular edema or retinal deposits are often reversible, Dr. Chalam said.

    A variety of pharmacologic agents can cause toxicity to the retina. While many of these can be grouped by anatomic location or type of toxicity, there are also individual medications with characteristic effects. In this article, we will describe several major categories of pharmacologic retinal toxicity and discuss examples of individual medications. Chloroquine (Aralen) and hydroxychloroquine (Plaquenil) are traditional antimalarial agents now used in the treatment of autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Both medications have been shown to bind melanin and to concentrate in the iris, ciliary body and retinal pigment epithelium, altering normal physiologic function. Early on, patients may be entirely asymptomatic, with only blunting of the foveal reflex and RPE granular pigmentary changes. With progression, symptoms can include blurred vision, decreased vision, scotomas and photopsias. While systemic medications are often necessary for the patient’s long-term health, ocular side effects, as minor as dry eye and as serious as macular toxicity, can challenge the treatment process, often leading to modification or even discontinuation of the medication. Optometrists must be prepared to manage and comanage patients who present with concurrent medication use and ocular concerns. Here, we discuss some of the commonly prescribed systemic medications with serious ocular side effects, and what to look out for. In the United States, Plaquenil (hydroxychloroquine, Sanofi-Aventis) is commonly used to treat rheumatic conditions such as rheumatoid arthritis, systemic lupus erythematosus and Sjögren’s syndrome. Plaquenil use has the potential risk of retinal toxicity. Hydroxychloroquine binds to melanin, which concentrates in the retinal pigment epithelium and prolongs the effects, even after discontinuation of the medication. Tamoxifen use and renal disease can also result in increased risk.

    Tamoxifen ocular side effects

    Know Your Systemic Meds The Top 10 to Track - Review of Optometry, Ophthalmic Metastasis of Breast Cancer and Ocular Side Effects from.

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  3. Find information about common, infrequent and rare side effects of Tamoxifen Oral.

    • Common and Rare Side Effects for Tamoxifen Oral - WebMD.
    • Watch for Ocular Effects of Breast Cancer Drugs - American..
    • Side Effects of Tamoxifen.

    Ocular toxicity affecting the cornea, ciliary body and retina. HCQ binds strongly to. Tamoxifen is a selective oestrogen receptor modulator that is widely used in. David I. Kaufman, DO, who participated in a study of the ocular side effects of tamoxifen, noted that, with tamoxifen specifically, there is a potential for patients to. Side Effects. Drug information provided by IBM Micromedex Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

     
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