摘要目的:观察他莫昔芬视网膜病变患眼的多模式影像特征。方法:回顾性病例研究。2019年1月至2021年12月于唐山市眼科医院检查确诊的他莫昔芬视网膜病变患者4例8只眼纳入研究。患者均为女性，双眼患病；年龄（59.5±4.6）岁。乳腺癌切除手术后连续口服他莫昔芬20 mg/d，其中口服时间5、7、≥10年分别为1、1、2例。患眼均行眼底彩色照相、光相干断层扫描（OCT）、OCT血管成像（OCTA）、荧光素眼底血管造影（FFA）、眼底自身荧光（AF）检查。观察患眼的眼底多模式影像特征。结果:所有患眼均可见黄斑区视网膜黄白色点状结晶样物质沉积。眼底AF检查，黄斑区均可见斑片样强AF。FFA检查，晚期黄斑区视网膜毛细血管扩张、荧光素渗漏。OCT检查，黄斑区神经上皮层间均可见点状强反射，其中神经上皮层间空腔形成、椭圆体带（EZ）中断、外板层裂孔形成分别为4、5、3只眼；黄斑区神经节细胞厚度降低7只眼。OCTA检查，拱环周围视网膜浅层毛细血管丛血流密度减低，其中视网膜小静脉扩张2只眼；深层毛细血管丛（DCP）毛细血管扩张。结论:他莫昔芬视网膜病变黄斑区可见黄白色点状结晶样物质沉积；神经上皮层间点状强反射、空腔形成、神经节细胞层变薄、EZ中断及外板层裂孔；拱环周围DCP毛细血管、小静脉扩张；黄斑区毛细血管扩张；黄斑区片状强AF。

abstractsObjective:To observe the multimodal imaging characteristics of tamoxifen retinopathy.Methods:A retrospective case study. From January 2019 to December 2021, 4 patients (8 eyes) with tamoxifen retinopathy diagnosed in Tangshan Eye Hospital were included in the study. All patients were female, with sick binoculus. The age was 59.5±4.6 years. After breast cancer resection, tamoxifen 20 mg/d was taken orally consecutively, including 1, 1, and 2 cases who took tamoxifen orally for 5, 7, and ≥10 years. All eyes were examined by fundus color photography, optical coherence tomography (OCT), OCT angiography (OCTA), fundus fluorescein angiography (FFA), and fundus autofluorescence (AF). The multi-mode image features of the fundus of the affected eyes were observed.Results:The yellow white dot crystal like material deposition in the macular area was observed in all eyes. In fundus AF examination, macular area showed patchy strong AF. FFA examination showed telangiectasia and fluorescein leakage in macular area at late stage. OCT showed that punctate strong reflexes could be seen between the neuroepithelial layers in the macular region with the formation of a space between the neuroepithelial layers, the interruption of the elliptical zone (EZ), and the formation of a hole in the outer lamella including 4, 5 and 3 eyes; The thickness of ganglion cells in macular region decreased in 7 eyes. OCTA showed that the blood flow density of the superficial retinal capillary plexus around the arch ring was decreased, and the retinal venules were dilated in 2 eyes; Deep capillary plexus (DCP) showed telangiectasia.Conclusion:Deposition of yellowish white dot like crystals can be seen in the macular region of tamoxifen retinopathy; dotted strong reflex between neuroepithelial layers, cavity formation, thinning of ganglion cell layer, EZ middle fissure and outer lamellar fissure; DCP capillaries and venules around the arch were dilated; telangiectasia in macular region; flaky strong AF in macular region.