title: Tamoxifen therapy conveys increased risk of developing a macular hole.
abstract: OBJECTIVE
  To determine etiological factors in the development of, as well as anatomic success rate and visual outcome of a large consecutive series of macular hole surgeries.
  
  
  METHODS
  Retrospective analysis of 300 consecutive cases of macular hole surgery by a single surgeon (RDB) between 1999 and 2003. Patients' medical and surgical histories were recorded and analysed for factors involved in aetiology and visual outcome.
  
  
  RESULTS
  There were 8 (4.12%) women, on tamoxifen in the study, two of these women had bilateral macular holes. When this study prevalence of tamoxifen therapy (4.12%) was compared to the estimated percentage of women in the same age group in the Australian population on tamoxifen (0.82%), a statistically significant difference (p value 0.0001) was found. Analysis of the number of bilateral holes in the tamoxifen group compared to the non-tamoxifen group was suggestive of an increased incidence of bilateral holes but not to a significantly significant degree.
  
  
  CONCLUSIONS
  Whilst no published reports link tamoxifen and macular holes, this may be due to the low incidence of the condition. Our study demonstrates a strong link between tamoxifen use and macular holes. Patients being commenced on tamoxifen should be advised of possible ocular complications and receive prompt ophthalmic review if symptoms develop.
authors.affiliation: bgcronin@optusnet.com.au
authors.forename: Brendan G
authors.initials: BG
authors.lastname: Cronin
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Lekich
authors.forename: Robert D
authors.initials: RD
authors.lastname: Bourke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D004965:Estrogen Antagonists / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012167:Retinal Perforations / Q000139:chemically induced* / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013629:Tamoxifen / Q000009:adverse effects*; D014821:Vitrectomy
chemical_list: D004965:Estrogen Antagonists; D013629:Tamoxifen