Atrophic tamoxifen maculopathy

Tamoxifen maculopathy is characterized by perifoveal white refractile deposits associated with pigmentary changes and cystoid macular edema. We report a case of atrophic maculopathy related to tamoxifen in a 70-year-old patient. Fundus examination showed refractile deposits in the macula predominantly in the left eye. Fundus autofluorescence demonstrated foveolar autofluorescence in both eyes. Fluorescein angiogram showed bilateral foveolar hyperfluorescence without leakage in the late phase. Optical coherence tomography disclosed an interruption of the photoreceptor layer in both eyes with a foveolar cystoid space. Multifocal electroretinogram showed bilateral alteration of the foveolar pic. The perifoveal foveolar cyst disappeared on OCT after discontinuation of tamoxifen. This case highlights the usefulness of optical coherence tomography and multifocal electroretinogram in the early diagnosis of atrophic form of tamoxifen maculopathy.