Intraocular penetration of tamoxifen

Objectives To document ocular penetration of oral tamoxifen in patients bei ng administered systemic therapy by measuring intraocular and serum levels of the drug in a series of patients undergoing elective ocular surgery. Designs Nonrandomized, prospective, comparative trial. Participants: Twenty-one eyes of 21 patients undergoing elective ocular sur gery (cataract extraction or vitrectomy). Twenty patients were using the an tiestrogen, tamoxifen, and one participant was not. Nine patients were excl uded in the final analysis because of inadequate sample size. Interventions Preoperative serum samples and perioperative aqueous samples, vitreous samples, or both were obtained for each patient, and these were a nalyzed for tamoxifen and its metabolites. Dilated fundus examination was p erformed before surgery on all patients. Main Outcome Measures: Evidence of tamoxifen, its metabolites, or both in t he samples. Results: Tamoxifen was detected in all analyzed serum samples (range, 82.4- 290.0 ng/ml.) from patients taking the medication and was found to have pen etrated into both vitreous (range, 0.5-7.8 ng/ml) and aqueous (range, 0.5-3 .9 ng/ml) cavities. No relationship was found between serum and intraocular levels. Conclusions: This study shows that tamoxifen penetrates intraocular fluids to varying degrees. The drug levels in aqueous and vitreous do not appear t o correlate with serum levels, Evidence of tamoxifen retinopathy or keratop athy was not seen. Ophthalmology 2000;107:2006-2009 (C) 2000 by the America n Academy of Ophthalmology.