他莫昔芬眼毒性的临床分析

Ocular toxicity associated with tamoxifen therapy to breast cancer

  • 摘要: 目的: 临床分析他莫昔芬(三苯氧胺,TAM)对眼的毒性。方法: 47例行乳腺切除的乳腺癌患者,口服TAM 2 0~6 0mg/d。监测视力变化,用裂隙灯、眼底镜、眼底荧光血管造影(FFA)、自动视野检查,观察可能出现的眼组织的毒性损害。结果: 平均随访时间45月(2~79月)。47例(94眼)中2例(3眼,4 2%)于服药后2月和9月出现视力下降,黄斑周视网膜内黄白色点状结晶及黄斑水肿,FFA显示结晶为低荧光和黄斑区渗漏。TAM总剂量为5 4和12 6g。降低药量后视力恢复,点状沉积减少,黄斑水肿消退。结论: TAM可引起可逆性视网膜毒性损害,损害发生率低,与剂量和用药时间无明显的线性关系。

     

    Abstract: Objective: To Investigate the ocular toxicity related to tamoxifen therapy to breast cancer. Methods: 47 cases of breast cancer underwent mastectomy took 20~60 mg per day of tamoxifen Visual acuity was measured with Snellen chart Intensive ophthalmic examinations were performed, including slit lamp, ophthalmoscope, funds fluorescein angiography (FFA), automated perimeter Any Ocular toxicity was recorded and analyzed. Results: Mean follow up period was 45 months (range, 2 to 79 moths) Decline of visual acuity in 2 cases (3 eyes) out of 47 cases (94 eyes) (4 2%) happened in 2 moths and 9 moths after taking tamoxifen, respectively Perimacular refraction yellow white deposits in retina and macular edema were found at that time FFA demonstrated the fluorescein leakage in macular and fluorescein block in deposit dots Total dosages of tamoxifen at that time were 5 4 g and 12 6 g, respectively Visual acuity improved, the number of deposites reduced and macular edema resolved following taper of tamoxifen dosages. Conclusion: Tamoxifen can lead reversible retinopathy at lower coincidence Linear relationship between tamoxife dosage and ocular toxicity cannot be conformed.

     

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