J Korean Ophthalmol Soc.  2016 Nov;57(11):1806-1811. 10.3341/jkos.2016.57.11.1806.

A Case of Bilateral Branch Retinal Vein Occlusion after Taking Tamoxifen

• Lee J
• Yeom MI
• Lee CK
• Park JM

• KMID: 2357741
• DOI: http://doi.org/10.3341/jkos.2016.57.11.1806

Abstract

PURPOSE
To report a case of bilateral branch retinal vein occlusion development after taking long-term tamoxifen adjuvant therapy.
CASE SUMMARY
A 72-year-old female breast cancer patient with a 10-year history of tamoxifen intake presented with decreased visual acuity that began 5 years prior. The patient had no other past history. The best corrected visual acuity (BCVA) was 0.3 in the right eye and 0.04 in the left eye. There was no specific finding of anterior segment on slit lamp examination. On fundus examination, sheathed branch retinal veins were observed in the inferotemporal area of the right eye and superotemporal and inferotemporal areas of the left eye. Microangiopathies were observed around the occluded branch retinal veins in both eyes and macular edema was present in the left eye. Laser photocoagulation was performed at the non-perfusion area in both eyes and an intravitreal injection of bevacizumab and 3 intravitreal injections of triamcinolone were administered into the left eye. The BCVA did not change after 3 years and remained relatively stable.
CONCLUSIONS
If a patient presents with decreased visual acuity after taking tamoxifen, fundus examination and fluorescein angiogram should be performed due to the possibility of branch retinal vein occlusion.

Keyword

Bilateral branch retinal vein occlusion; Breast cancer; Tamoxifen

MeSH Terms

Aged
Bevacizumab
Breast Neoplasms
Female
Fluorescein
Humans
Intravitreal Injections
Light Coagulation
Macular Edema
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Slit Lamp
Tamoxifen*
Triamcinolone
Visual Acuity
Bevacizumab
Fluorescein
Retinaldehyde
Tamoxifen
Triamcinolone

Figure

• 

  Figure 1. Color fundus photopgraphs of the both eyes. (A) Color fundus photography of the right eye showing sheathed retinal vessel in inferotemporal area with old laser scars. Hyperreflective crystalline dot-like deposits at superior perifoveal area were seen. (B) Color fundus photography of the left eye demonstrating sheathed retinal vessels with old laser scars in superotemporal and inferotemporal area.

• 

  Figure 2. Fluorescein angiogram of the both eyes. (A) Early venous phase fluorescein angiogram of the right eye showing lack of perfusion (arrowhead) in inferotemporal second branch retinal vein. (B) Early venous phase fluorescein angiogram of the left eye showing occlusions (arrowheads) in superotemporal second brach and inferotemporal first brach retinal vein. Late venous phase fluorescein angiogram of the right eye (C), and left eye showing non-perfusion area in inferotemporal regions in the left eye (D). Late phase fluorescein angiogram of the right eye (E) and left eye (F) demonstrating fluorescein leakage.

• 

  Figure 3. Optical coherence tomographs of the both eyes. Optical coherence tomography showing retinal cysts on temporal parafoveal area with retinal atrophy in the right eye (A) and cystoids macular edema in the left eye (B).

• 

  Figure 4. Optical coherece tomographs and venous phase fluorescein angiogram of the both eyes 3 years after the first visit. Optical coherence tomography demonstrating retinal atrophy on temporal macula of the right eye (A), and cystoid macular edema in the left eye (B). Venous phase fluorescein angiogram of the right eye (C) and left eye (D) showing non-perfusion area in both eyes.

Reference

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