Reduction of macular pigment as early feature of tamoxifen retinopathy

Session Details

Session Title: Free Paper Session 17: Imaging II

Session Date/Time: Saturday 09/09/2017 | 08:00-09:30

Paper Time: 08:00

Venue: Room 120

First Author: : C.Preziosa ITALY

Co Author(s): :    I. D'agostino   U. Nava   M. Cozzi   M. Cigada   M. Pellegrini   G. Staurenghi              

Abstract Details

Purpose:

Tamoxifen retinopathy is a condition characterized by cavitations occurring in the central macula at Spectral Domain - Optical Coherence Tomography (SD-OCT) imaging; these alterations appear similar to changes occurring in macular telangiectasia type 2 where a reduction of macular pigment has been already established with toxicity primarily affecting retinal Muller cells. In this study we investigated macular pigment density in patients treated with Tamoxifen for breast cancer.

Setting:

Prospective observational study conducted at the Eye Clinic, department of Biomedical and Clinical Science “Luigi Sacco”, Sacco Hospital, University of Milan, Milan.

Methods:

To compare the macular pigment optical density (MPOD) in 30 patients treated with Tamoxifen (20 mg daily) and 16 healthy subjects matched by age. The MPOD was measured by means of the two-wavelengths autofluorescence (AF) technique (488 and 514 nm) using the Heidelberg HRA + OCT Spectralis (Heidelberg Engineering, Heidelberg, Germany). MPOD maps were generated by automatic subtraction of the log AF images using the inbuilt Eye Explorer software (HEYEX).

Results:

Mean MPOD at peak was 0,69 ± 0,18 density units (DU) and 0,78 ± 0,14 respectively in Tamoxifen and control group (P = 0,07). In Tamoxifen group the mean MPOD at 0,5° eccentricity was 0,58 ± 0,14, at 1° was 0,54 ± 0,13 and at 2° was 0,34 ± 0,1 while in the control group it was 0,62 ± 0,16 at 0,5° eccentricity, 0,55 ± 0,13 at 1° and 0,32 ± 0,06 at 2° (P > 0,05). The radius at half peak of MPOD was located at 1,4 and 1,1 degrees from fovea respectively in Tamoxifen group and in healthy subjects (P = 0,0076). A linear regression investigated the relation between the duration of treatment (mean 32 months, min 10 max 60) and the MPOD at peak, showing a weak inverse correlation (r = -0,35, P = 0,051).

Conclusions:

In our series patients treated with Tamoxifen likely showed a reduction of MPOD levels at peak, 0,5° and 1° eccentricity compared to control group; nevertheless these differences were not statistically significant. The radius at half peak of MPOD in Tamoxifen group was statistically significant farther from the fovea compared to control group, suggesting an alteration in macular pigment distribution in patients treated with Tamoxifen probably due to a reduction of macular pigment nearby the fovea.

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