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Nov 28, 2009 10:42AM
Google is your friend! I was looking into this last week - isn't there an insert that comes with the drug that has the side effects info printed on it? I haven't started taking the drug yet, but I thought I'd investigate and I found some sort of official warning thing on the web, it seemed like it came in the packaging. Of course now I can't find it. But I did find these:
Tamoxifen is a drug used in the treatment of breast cancer. Ocular side effects consist of crystalline retinopathy, corneal deposits, and optic neuritis. Ocular side effects to tamoxifen are relatively rare, with the reported incidence in the literature varying between 0.9% and 12%. There is evidence of retinal nerve fiber degeneration. Cessation of treatment usually prevents further deterioration but may not result in visual recovery.
Effects on the Eye
Ocular disturbances, including corneal changes, decrement in color vision perception, retinal vein thrombosis, and retinopathy have been reported in patients receiving Tamoxifen. An increased incidence of cataracts and the need for cataract surgery have been reported in patients receiving Tamoxifen.
In the NSABP P-1 trial, an increased risk of borderline significance of developing cataracts among those women without cataracts at baseline (540-Tamoxifen; 483-placebo; RR = 1.13, 95% CI: 1.00 to 1.28) was observed. Among these same women, Tamoxifen was associated with an increased risk of having cataract surgery (101-Tamoxifen; 63-placebo; RR = 1.62, 95% CI 1.18 to 2.22) (see Table 3 in CLINICAL PHARMACOLOGY). Among all women on the trial (with or without cataracts at baseline), Tamoxifen was associated with an increased risk of having cataract surgery (201-Tamoxifen; 129-placebo; RR = 1.58, 95% CI 1.26 to 1.97). Eye examinations were not required during the study. No other conclusions regarding non-cataract ophthalmic events can be made.
Tamoxifen-associated eye disease. A review
SG Nayfield and MB Gorin
Chemoprevention Branch, National Cancer Institute, Bethesda, MD, 20892, USA.
PURPOSE: The oral antiestrogen tamoxifen has demonstrated efficacy in the treatment of metastatic breast cancer and as adjuvant therapy in early-stage disease. Clinical trials of tamoxifen in chemoprevention of breast cancer among high-risk women have focused attention on potential adverse effects of long-term tamoxifen use, including the possibility of ocular toxicity. This review evaluates the published case reports, clinical series, and clinical trial data on ocular toxicities attributed to tamoxifen. Clinical issues of surveillance, differential diagnosis, and management of tamoxifen-related eye disease are discussed. DESIGN: National Library of Medicine online bibliographic services were used to identify case reports and clinical studies of ocular adverse effects that occurred in patients receiving tamoxifen published through the fall of 1994. The medical literature relevant to issues raised by the reports and studies was similarly identified and reviewed. RESULTS: Case reports and case series identify crystalline retinal deposits, macular edema, and corneal changes as potential tamoxifen ocular toxicities. Extensive retinal lesions and macular edema with visual impairment have been reported in a few patients receiving high-dose tamoxifen. Less extensive retinal changes may occur in patients receiving low doses for long periods, and isolated retinal crystals may be observed in patients without visual symptoms. CONCLUSION: Ocular toxicity is uncommon in the current clinical setting of long-term, low-dose tamoxifen use. Physicians should be aware of the potential for ocular toxicity among patients receiving the drug and should assure appropriate surveillance and prompt evaluation of visual complaints.
8/2009, DCIS, Stage 0, Grade 3, ER+/PR+