RESUMO
PURPOSE: To estimate the prevalence of abnormalities in visual function and ocular structures associated with the long-term use of tamoxifen citrate. METHODS: A single-masked, cross-sectional study involving multiple community and institutional ophthalmologic departments was conducted with a volunteer sample of 303 women with breast cancer currently taking part in a randomized clinical trial to determine the efficacy of tamoxifen (20 mg/day) in preventing recurrences. Participants included women who had never been on drug (n=85); women who had taken tamoxifen for an average of 4.8 years, then been off the drug for an average of 2.7 years (n=140); and women who had been on tamoxifen continuously for an average of 7.8 years (n=78). Women were evaluated by questionnaire, psychophysical testing, and clinical examination to determine any abnormalities in visual function and the comparative prevalences of corneal, lens, retinal, and optic nerve pathology. RESULTS: There were no cases of vision-threatening ocular toxicity among the tamoxifen-treated participants. Compared with nontreated participants, the tamoxifen-treated women had no differences in the activities of daily vision, visual acuity measurements, or other tests of visual function except for color screening. Intraretinal crystals (odds ratio [OR]=3.58, P=.178) and posterior subcapsular opacities (OR=4.03, P=.034) were more frequent in the tamoxifen-treated group. CONCLUSIONS: Women should have a thorough baseline ophthalmic evaluation within the first year of initiating tamoxifen therapy and receive appropriate follow-up evaluations.
Assuntos
Antineoplásicos Hormonais/efeitos adversos , Oftalmopatias/induzido quimicamente , Tamoxifeno/efeitos adversos , Visão Ocular/efeitos dos fármacos , Idoso , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/prevenção & controle , Catarata/induzido quimicamente , Estudos Transversais , Feminino , Humanos , Cristalino/efeitos dos fármacos , Estudos Longitudinais , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Prevalência , Retina/efeitos dos fármacos , Doenças Retinianas/induzido quimicamente , Método Simples-Cego , Tamoxifeno/uso terapêutico , Testes VisuaisRESUMO
To ascertain the prevalence rate of presumed photic retinopathy after cataract surgery, 276 fluorescein angiograms of 147 patients were reviewed. The diagnosis was based on strict angiographic criteria. Lesions consistent with healed photic retinopathy were noted in four patients (prevalence rate of 3%). This finding is discussed and comparisons with the literature are made.
Assuntos
Extração de Catarata , Luz/efeitos adversos , Retina/efeitos da radiação , Doenças Retinianas/etiologia , Angiofluoresceinografia , Flurbiprofeno/uso terapêutico , Seguimentos , Fundo de Olho , Humanos , Indometacina/uso terapêutico , Recém-Nascido , Edema Macular/tratamento farmacológico , Prevalência , Lesões por Radiação/etiologiaRESUMO
This retrospective study reviews the efficacy of panretinal photocoagulation in the prevention and management of ocular neovascularization in 55 cases of central retinal vein occlusion. Differentiation of occlusions into ischemic and nonischemic forms is of critical importance, with aggressive laser treatment being warranted in the ischemic variety. The presence of ocular neovascularization may not necessarily imply a grim prognosis.