Effectiveness of Low-Dose Tamoxifen for Managing Ocular Manifestations in Breast Cancer Patients

Background: Breast cancer remains one of the most common malignancies worldwide, with hormonal therapies like tamoxifen significantly improving survival rates in hormone receptor-positive cases. However, tamoxifen’s systemic effects can lead to adverse outcomes, including ocular manifestations such as cataracts, retinopathy, and optic neuritis. These complications, although rare, may impact quality of life, prompting a focus on low-dose tamoxifen to mitigate risks while preserving efficacy. Objective: This study evaluates the ocular outcomes of low-dose tamoxifen in breast cancer patients, aiming to explore its safety and implications for long-term therapy. Methods: A longitudinal study was conducted at Dhaka Medical College Hospital between October 2019 and July 2020. Sixty breast cancer patients treated with low-dose tamoxifen for more than two years were evaluated through detailed ophthalmic examinations, including visual acuity tests, slit lamp biomicroscopy, color fundus photography (CFP), and optical coherence tomography (OCT). Data were analyzed using SPSS software. Results: Among the participants, 11.1% (n=5) exhibited ocular manifestations, including cataracts (6.7%), retinitis (2.2%), and optic neuritis (2.2%). These complications were associated with extended tamoxifen therapy (27–33 months). The findings suggest a correlation between prolonged tamoxifen use and ocular toxicity, although the prevalence was relatively low. Conclusion: Low-dose tamoxifen was associated with minimal ocular side effects, supporting its viability as a safer alternative for long-term therapy in breast cancer patients. Comprehensive ophthalmic evaluation before and during treatment is recommended to ensure early detection and management of potential complications.