Toxic maculopathy

Crystal retinopathy which can occur in tamoxifen 
or canthaxanthine retinopathy
Tamoxifen is now commonly used as an adjuncvitve treatment in women with breast carcinoma. As breast cancer is 
common you may be given cases of tamoxifen retinopathy in the examination. However, tamoxifen is not the only 
drug that causes crystalline retinopathy and you need to know the differenital diagnosis (see questions).

There are bilateral intraretinal perifoveal refractile crystals (there may be associated macular oedema).

Further examination:

  • in women mention that you would like to know if there were any past history of breat problem. Also examine the 

  • patient's arm for any evidence of lymphoedema (which can occur from lymph node removal during mastectomy)


1. What are the causes of crystalline retinopathy apart from tamoxifen?

2. Should tamoxifen be stopped in patients with crystalline retinopathy?

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