Tamoxifen therapy conveys increased risk of developing a macular hole

Int Ophthalmol. 2005 Jun;26(3):101-5. doi: 10.1007/s10792-005-5424-3. Epub 2006 Sep 15.


Purpose: 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.

Conclusion: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Estrogen Antagonists / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Prevalence
  • Prognosis
  • Retinal Perforations / chemically induced*
  • Retinal Perforations / epidemiology
  • Retinal Perforations / surgery
  • Retrospective Studies
  • Risk Factors
  • Tamoxifen / adverse effects*
  • Vitrectomy


  • Estrogen Antagonists
  • Tamoxifen