Microcystoid maculopathy associated with tamoxifen use diagnosed by high-resolution fourier-domain optical coherence tomography

Retin Cases Brief Rep. 2009 Winter;3(1):33-5. doi: 10.1097/ICB.0b013e31815e93cf.

Abstract

Purpose: To describe a case of microcystoid maculopathy diagnosed by high-resolution Fourier-domain optical coherence tomography (Fd-OCT) in a patient treated with tamoxifen who had previously unexplained vision loss.

Methods: Report of a case of a 66-year-old woman treated with tamoxifen for 4 years who had progressive unexplained vision loss in the left eye for 2 years.

Results: Visual acuity was 20/25 in the right eye and 20/70 in the left eye. Findings of funduscopy and fluorescein angiography were unremarkable except for minimal pigment alteration in the macula in the left eye. Stratus OCT showed possible microcystoid changes in the fovea in both eyes. Fd-OCT revealed scattered intraretinal microcystoid changes and patches of focal loss of photoreceptors in the macula in both eyes with foveal involvement in the left eye. Full-field electroretinogram was normal. Multifocal electroretinogram showed some decreased response in the peripheral macula and borderline low foveal response in both eyes.

Conclusion: Microcystoid maculopathy associated with tamoxifen use can be diagnosed by Fd-OCT in a normal appearing fundus. It can present as unexplained vision loss.